RESUMO
OBJECTIVE: To evaluate a new ambulatory care system in outpatient child and adolescent psychiatry based on the web-based Development and Well-Being Assessment (DAWBA). METHODS: We analyzed patient paths (flows), acceptance, satisfaction, and staff costs in the newly implemented care model. RESULTS: The new model was very well accepted by the respondents (DAWBA response rate: 92â%). A third of the patients registered with the psychiatric service in 2012 were not in need of psychiatric treatment and were therefore referred to other psycho-social services. The additional staff costs of $ 200 per case might be low compared to the saved costs due to the avoidance of inappropriate medical care. CONCLUSION: The new ambulatory care model proved to be effective, efficient and broadly accepted when resources are strictly limited.
Assuntos
Psiquiatria do Adolescente/organização & administração , Assistência Ambulatorial/organização & administração , Psiquiatria Infantil/organização & administração , Aceitação pelo Paciente de Cuidados de Saúde , Adolescente , Psiquiatria do Adolescente/economia , Assistência Ambulatorial/economia , Criança , Redução de Custos , Humanos , Satisfação do Paciente/economia , Encaminhamento e Consulta/economia , Encaminhamento e Consulta/organização & administração , Suíça , Triagem/economia , Triagem/organização & administraçãoRESUMO
Although relatively rare, suicide is a leading cause of death in children and adolescents in the Western world. This study examined whether children and adolescents are drawn to other methods of suicide than adults. Swiss suicides from 1998 to 2007 were examined. The main methods of suicide were analysed with respect to age and gender. Of the 12,226 suicides which took place in this 10-year period, 333 were committed by children and adolescents (226 males, 107 females). The most prevalent methods of suicide in children and adolescents 0-19 years were hanging, jumping from heights and railway-suicides (both genders), intoxication (females) and firearms (males). Compared to adults, railway-suicides were over-represented in young males and females (both P < .001). Jumping from heights was over-represented in young males (P < .001). Thus, availability has an important effect on methods of suicide chosen by children and adolescents. Restricting access to most favoured methods of suicide might be an important strategy in suicide prevention.
