RESUMO
OBJECTIVE: There are three aims of this report. First, to describe how research evidence informed a service development rationale for a new statewide eating disorder service (SEDS) for people aged 15 years and older. Second, to examine the profile of people accessing SEDS in the first 2 years of its operation with respect to the three broad dimensions: illness stage, illness severity, and previous history of treatment. Finally, to examine which patient characteristics resulted in the recommendation of ongoing treatment contact with SEDS. METHOD: Over a 2-year period (July 2014 to July 2016) 292 people were referred to the service, 171 (59%) who consented to have their data used in research. RESULTS: Half of the referrals related to anorexia nervosa (AN; 51.2%), with the remainder split between bulimia nervosa (25.3%) and other specified feeding and eating disorders (23.5%); 65.9% had previously received treatment for an eating disorder. The initial information about the service was typically provided by the general practitioner/primary care physician. Compared with any other eating disorder diagnosis, people with AN were three times more likely to be recommended to retain treatment contact with SEDS. DISCUSSION: Service development informed by research evidence, clinical expertise, and consideration of patients' characteristics, values, and circumstances, allows for a flexible but accountable development strategy.
Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/economia , Anorexia Nervosa/terapia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/economia , Bulimia Nervosa/terapia , Serviços Comunitários de Saúde Mental/economia , Medicina Baseada em Evidências , Transtornos da Alimentação e da Ingestão de Alimentos/economia , Feminino , Organização do Financiamento , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Qualidade de Vida , Encaminhamento e Consulta , Autoeficácia , Austrália do Sul , Adulto JovemRESUMO
OBJECTIVES: The objective of this study was to describe the history of South Australian Government eating disorder service from the perspective of changing leadership, health policies and politics. CONCLUSIONS: The history reveals a foundation of early expert academic clinical leadership changing into a centralised managerial bureaucracy correlating with a diminution of services. A threat to the survival of the service led to a solution involving reinvigoration of expert clinical and academic leadership. Expert leadership was shown to be an important part of an eating disorder service.