摘要目的：探索中山市个案管理服务对社区精神障碍患者住院时间的影响。方法个案管理试点区域15岁以上的重性精神障碍患者根据自愿原则被分为个案管理组65例和基础管理组112例。比较两组住院次数、住院时间在个案管理服务开展前后的差异。结果采用混合线性模型进行分析，个案管理组和基础管理组次均住院时间在管理实施后均呈下降趋势（F=11.02，P=0.001），个案管理组优于基础管理组（F=9.02，P=0.003）。个案管理组年人均住院次数高于基础管理组（F=4.98，P=0.03）。两组的年平均住院率在实施个案管理前后的差异无统计学意义（个案管理组5.13%vs.5.38%，基础管理组7.14%vs.8.92%，P>0.05)。结论社区个案管理服务能显著减少住院时间。开展社区个案管理服务可能有助于精神卫生资源在医院和社区之间的平衡分配。

abstractsObjective To examine the impact of case management on hospitalizations of the chronically and severely mentally ill patients in Zhongshan. Methods Patients with severe and chronic mental illness,aged ≥ 15 years and living in pilot area were divided into two groups naturally since the program of case management launched, 65 cases in the group of case management and 112 patients in the group of standard management. Hospitalizations of the two groups before and after case management were compared. Results Data were analysised with MIXED procedure. Length of stay in days per admission (LOS) of both groups decreased with time in years (F=11.02, P=0.001), and the decline in LOS of case management group was greater than that of standard management group (F=9.02, P=0.003). The average admissions of case management group was more than that of standard management group (F=4.98,P=0.03). There was no significant differences in average hospitalization incidents before and after case management in both groups(case management group 5.13%vs. 5.38%, standard management group 7.14%vs. 8.92%, P>0.05). Conclusions Case management was effective in reducing hospitalizations for a group of Chinese with chronic and severe mental illness, and may contribute to the balance on mental health resources between community and hospital.