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Assistenza psichiatrica e monitoraggio dei servizi. Il Registro dei casi di Arezzo 1987–1990

Published online by Cambridge University Press:  11 October 2011

Paolo Martini*
Affiliation:
Unità Operativa di Psichiatria, ULSS 23 della Regione Toscana, Arezzo
Franco Domenici
Affiliation:
Unità Operativa di Psichiatria, ULSS 23 della Regione Toscana, Arezzo
*
Indirizzo per la corrispondenza: Dr. P. Martini, Unità Operativa di Psichiatria, Via G. Monaco 13, 52100 Arezzo. Fax (+39) 0575-305.503

Abstract

Riassunto

Sono descritte, con la stessa metodologia impiegata in altre 4 aree italiane, sedi di registri psichiatrici dei casi (RPC), le caratteristiche della catchment-area, del RPC, della struttura e dei principi del Servizio di Salute Mentale di Arezzo. II monitoraggio della domanda su 4 anni evidenzia che i tassi di prevalenza annua (1537/100000 15 + ) e un giorno (714/100000 15 + ), specie per le psicosi funzionali, hanno valori vicini ai RCP europei. Con la incidenza (256/100000 15 + ), i tassi indicano un coverage e una presa in carico dei principali bisogni psicopatologici di popolazione di area. II monitoraggio dei servizi offerti evidenzia la chiusura dell'OP nel 1989 con dimissione dei lungodegenti e 1'espansione considerevole delle attivita e degli utenti in molteplici strutture e servizi a differente gradiente assistenziale, residenziali (66/100000 15 + ospitati nel 1990), diurni (205/100000 15 + utenti nel 1990), di inserimento lavorativo, domiciliari, ambulatoriali e ospedalieri, che ruotano intorno a un Centro con équipe in mobilita e aperto 24h/24 e 7 gg./7. II rapporto tra prevalenza annua non ospedaliera e ospedaliera e nel 1990 di 20:1; l'intervento precoce e alternativo consente un tasso medio di ammissioni ospedaliere di 86/100000 15 + con SPDC ma senza reparto e senza nuovi lungodegenti. II tasso di lungoassistiti (541/100000 15 + ) e il pattern di utilizzo dei servizi indicano una risposta continuativa, flessibile e integrata ad utenti per il 90% viventi nel proprio ambiente. II costo del Servizio e pari alia spesa storica dell'OP, rapportato alia popolazione e all'indice di costo ISTAT.

Parole chiave

servizi psichiatrici territoriali, registri psichiatrici dei casi, utilizzazione dei servizi.

Summary

The principles, structure, Psychiatric Case Register (PCR) and catchment-area of the Community Mental Health Service (CMHS) of Arezzo are described, using the same methodology employed in 4 other Italian PCRs. The monitoring of the demand over 4 years shows that the mean year prevalence (1537/100000 15 +) and day prevalence (714/100000 15 +) rates, especially for functional psychoses, are statistically close to European PCRs. Together with incidence (256/100000 15 +), those rates indicate full coverage and response to the principal psychopathological needs of the population of the area. The monitoring of the service shows: the closure of the psychiatric hospital in 1989 with the discharging of long-stay patients; the considerable expansion of activities and the number of users in multiple structures and services, offering different degrees of care; i.e. residential (66/100000 15+ users in 1990), day-centres (205/100000 15+ users in 1990), work emplacement, domiciliary care, out and in-patients. Those services revolve around the Centre (open round the clock, 7 days a week) with a mobile crisis intervention team. The ratio between hospitalized and non-hospitalized users is 1:20, for 1990; early and alternative intervention gives an average rate of hospital admissions of 86/100000 15+ in clinical and psychiatric beds but with no psychiatric ward and no new long-stay patients. The rate of long-term patients (541/100000 15 +) and the pattern of use of the services indicate an ongoing, flexible and integrated response to users needs, 90% of whom live in their own home environment. The costs of the CMHS work out equal to the former expenses of the psychiatric hospital, in ratio to inflation and the cost of living.

Type
Monitoraggio e Valutazione dei Servizi in 5 Aree di Registro. Uno Studio Epidemiologico Comparativo (a cura di D. De Salvia e M. Tansella) (Prima parte)
Copyright
Copyright © Cambridge University Press 1992

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References

Corlito, G., Nascimbeni, P., Cesari, G., Pennacchioni, A. & Petrillo, M. (1990). II servizio «psicoterapeutico»: teoria e pratica del servizio di salute mentale di Arezzo. In La Bottega dell'Anima (a cura di Benvenuto, S. e Nicolaus, O.), pp. 305318. Franco Angeli: Milano.Google Scholar
Lavik, N. J.. (1983). Utilization of mental health services over a given period. Acta Psychiatrica Scandinavica 67, 404413.CrossRefGoogle Scholar
Martini, P. (1989). I percorsi della riabilitazione. In La Riabilitazione nel Servizio di Salute Mentale (a cura di Martini, P. e Corlito, G.), pp. 2240. ETS: Pisa.Google Scholar
Martini, P. & Domenici, F. (1991). Rehabilitation und Arbeitskooperativen in einem gemeindepsychiatrischen Dienst ohne psychiatrisches Krankenhaus. In Psychiatrie-Reform in Europa (ed. Bauer, M., Engfer, R. und Rappl, J.), pp. 2558. Psychiatrie-Verlag: Bonn.Google Scholar
Martini, P., Cecchini, M., Corlito, G., D'Arco, A. & Nascimbeni, P. (1985). A model of a single comprehensive mental health service for a catchment area: a community alternative to hospitalization. In Focus on the Italian Psychiatric Reform (ed. Perris, C. and Kemali, D.), Acta Psychiatrica Scandinavica, Supplementum No. 316, vol. 71, pp. 95120.Google Scholar
Sytema, S., Balestrieri, M., Giel, R., ten Horn, G.H.M.M. & Tansella, M. (1989). Use of mental health services in South Verona and Groningen. Acta Psychiatrica Scandinavica 79, 153162.CrossRefGoogle ScholarPubMed
World Health Organization (1978). Mental Disorders: a Glossary and Guide to Their Classification in Accordance with the Ninth Revision of the International Classification of Diseases. WHO: Geneva.Google Scholar
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