Highlighted is the experience gained in the organization of a day hospital created for general and neurologic patients at Polyclinic N 166 of the Krasnogvardeisk region of Moscow. The preliminary outcomes of the treatment of 167 patients are briefly analyzed. The results of the study on the population's opinion on the exapediency of day hospitals are provided. It is pointed out that treatment in a day hospital is regarded as an advanced form of medical care.
Although AIDS is often thought of as a "big-city" disease, it is also becoming a serious health care issue for doctors and other health care workers in "small-city" Canada. Kingston, Ont., is one of those small cities, and of the facilities trying to come to grips with a disease about which much remains to be learned. In this article, Drs. Peter Ford and David Robertson outline their hospital's estimate of the cost, in manpower and money, of dealing with the AIDS crisis. The final estimate: roughly $700,000. Although most of the cost will involve one-time capital spending, they point out that there will likely be ongoing labour-related costs because of the special programs and increased manpower needed to deal with AIDS patients. Clearly, AIDS is no longer a big-city disease.
An account has been prepared describing the psychiatric treatment of preverbally deaf adults in Denmark during the period 01.01.1986 to 31.12.1991, as well as an analysis of these patients with regard to demographic and psychiatric characteristics. During this period 1231 outpatient treatments were recorded, pertaining to 168 patients. A total of 1.9-2.8% of the deaf adult population received specialised psychiatric treatment per year, either under hospitalization or as out-patients. The most dominant psychiatric diagnoses were functional psychoses (21%), serious personality disorders (25%) and affect reactions (15%). The educational levels and occupational circumstances og these patients were of a much lower standard than those of deaf adults in general. During the course of the investigation period a restructuring has taken place at the National Institution for the Deaf which has enabled a significant reduction in the duration of hospitalization in the Department of Psychiatry for the Deaf. The Institution for the Deaf now permanently accommodates 55 of the previously mentioned 168 out-patients (33%). This reorganisation has resulted in changes in the methods of treatment in the Department of Psychiatry for the Deaf towards hospitalizations of shorter duration for the treatment of acute exacerbations of serious psychiatric disorders as well as of forensic psychiatric patients.
The high readmission rates of discharged psychiatric patients have forced mental health professionals to play closer attention to aftercare planning. A program was developed at a psychiatric hospital in Ontario in 1977 to deal with "problem patients"--those who were deemed difficult to place in the community by the referral person or department. The program was characterized by shared institutional-community staffing, systematic aftercare assessment and planning, a crisis intervention approach to discharge, the use of a transitional staff member with patients, and the development of close relationships with community agencies. Study data show that the program was effective in limiting the number of readmissions during its first two years to 20 per cent.
Women with alcohol problems constitute an increasing number of patients in medical service. Do they need special care? How should the treatment program be designed? The specialized female Karolinska Project for Early Treatment of Women with Alcohol Addiction (EWA) unit at the Karolinska Hospital in Stockholm, Sweden, was opened in 1981. The aim of the project is to reach women in an early stage of alcohol dependence behavior and to develop treatment programs specific to the needs of females alone. In order to investigate the value of such a specialized female unit a controlled 2-year follow-up study was carried out including 200 women. The probands were treated in the female only EWA-unit, whereas the controls were placed in the care of traditional mixed-sex alcoholism treatment centers. The 2-year follow-up study showed a more successful rehabilitation regarding alcohol consumption and social adjustment for the women treated in the specialized female unit (EWA). Improvement was noted also for the controls but to a lesser extent. Probably one of the most important achievements of a specialized female unit, such as EWA, is to attract women to come for help earlier.