the effects of a nationwide program to reduce seclusion in the netherlands一个全国性的影响减少隐居在荷兰的项目.pdf
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Vruwink et al. BMC Psychiatry 2012, 12:231
/1471-244X/12/231
RESEARCH ARTICLE Open Access
The effects of a nationwide program to reduce
seclusion in the Netherlands
1* 2,3 4 5 6,7
Fleur J Vruwink , Cornelis L Mulder , Eric O Noorthoorn , Daan Uitenbroek and Henk LI Nijman
Abstract
Background: From 2006 to 2009, the Dutch government provided €5 m annually for a nationwide program to
reduce seclusion in psychiatric hospitals by 10% a year. We aimed to establish whether the numbers of both
seclusion and involuntary medication changed significantly after the start of this national program.
Methods: Using Poisson regression to estimate difference in logit slopes, we analyzed data for 1998–2009 from the
Dutch Health Care Inspectorate, retrospectively examining the national numbers of seclusion and involuntary
medication before and after the start of the program.
Results: The difference in slopes of the numbers of seclusion before and after the start of the program was
statistically significant (difference 5.2%: p 0.001). After the start of the program seclusions dropped 2.0% per year.
Corrected for the increasing number of involuntary hospitalizations this figure was 4.7% per year. The difference in
slopes of the numbers of involuntary medication did not change statistically significant (difference 0.5%, n.s.). After
correction for the increasing number of involuntary hospitalizations the difference turned significant (difference
3.3%, p = 0.002).
Conclusions: After the start of the nationwide program the number of seclusions fell, and although significantly
changing, the reduction was modest and failed to meet the objective of a 10% annual decrease. The number of
involuntary medi
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