RESUMO
Three models for the secondary prevention of alcoholism were considered: Asylum or Institution, Mental Health Unit and Comprehensive Program. All three were carried out using similar resources, at the same urban area, in succesion. Data were gathered from two sources: daily registers of Outpatient Services and clinical records, being the former of better quality. The Comprehensive Program, whose main characteristic is the integration of the community in the effort to solve its mental health problems, proved to have the greatest efficacity, according to the items selected for evaluation. The detection of new alcoholic patients was three or fourfold the two other models had; the detection was produced at much earlier stages, and the therapeutic performance and results were significantly higher. The costs, global as well as per capita, were much lower, and the use of institutional resources much more rational. The Mental Health Unit model meant a good professional performance at the specialized Psychiatric Services but showed rather poor results in detecting new cases, and costs much higher than those of the Comprehensive Program. The Asylum or Institution model showed the poorest levels of efficacity in all items, and the higher costs. The paper also analyzes some possible biases stemming from the general assumptions at the basis of the chosen evaluation system. It emphasizes the importance of general community leaders in primary prevention in reducing secondary prevention needs through education of the general population.
Assuntos
Alcoolismo/prevenção & controle , Chile , Serviços Comunitários de Saúde Mental , Planejamento em Saúde , Hospitalização , Humanos , Modelos TeóricosRESUMO
Three models for the secondary prevention of alcoholism were considered: Asylum or Institution, Mental Health Unit and Comprehensive Program. All three were carried out using similar resources, at the same urban area, in succesion. Data were gathered from two sources: daily registers of Outpatient Services and clinical records, being the former of better quality. The Comprehensive Program, whose main characteristic is the integration of the community in the effort to solve its mental health problems, proved to have the greatest efficacity, according to the items selected for evaluation. The detection of new alcoholic patients was three or fourfold the two other models had; the detection was produced at much earlier stages, and the therapeutic performance and results were significantly higher. The costs, global as well as per capita, were much lower, and the use of institutional resources much more rational. The Mental Health Unit model meant a good professional performance at the specialized Psychiatric Services but showed rather poor results in detecting new cases, and costs much higher than those of the Comprehensive Program. The Asylum or Institution model showed the poorest levels of efficacity in all items, and the higher costs. The paper also analyzes some possible biases stemming from the general assumptions at the basis of the chosen evaluation system. It emphasizes the importance of general community leaders in primary prevention in reducing secondary prevention needs through education of the general population.
RESUMO
Three models for the secondary prevention of alcoholism were considered: Asylum or Institution, Mental Health Unit and Comprehensive Program. All three were carried out using similar resources, at the same urban area, in succesion. Data were gathered from two sources: daily registers of Outpatient Services and clinical records, being the former of better quality. The Comprehensive Program, whose main characteristic is the integration of the community in the effort to solve its mental health problems, proved to have the greatest efficacity, according to the items selected for evaluation. The detection of new alcoholic patients was three or fourfold the two other models had; the detection was produced at much earlier stages, and the therapeutic performance and results were significantly higher. The costs, global as well as per capita, were much lower, and the use of institutional resources much more rational. The Mental Health Unit model meant a good professional performance at the specialized Psychiatric Services but showed rather poor results in detecting new cases, and costs much higher than those of the Comprehensive Program. The Asylum or Institution model showed the poorest levels of efficacity in all items, and the higher costs. The paper also analyzes some possible biases stemming from the general assumptions at the basis of the chosen evaluation system. It emphasizes the importance of general community leaders in primary prevention in reducing secondary prevention needs through education of the general population.