Alternativas a la hospitalización total en adolescentes con anorexia nerviosa: Eficacia y características de un nuevo modelo intensivo de tratamiento en hospital de día

2020 
espanolIntroduccion. La Hospitalizacion Total (HT) es el tratamiento de eleccion para adolescentes con Anorexia Nerviosa (AN) moderada-grave. Sin embargo, esta es costosa y el riesgo de recaida o reingresos es alto. Una alternativa menos costosa es la Hospitalizacion Parcial (HP), que puede ayudar a evitar recaidas y reingresos porque facilita la transicion del hospital al tratamiento comunitario. Objetivo. Evaluar la eficacia de un tratamiento intensivo en HP para adolescentes con AN, el programa de HP para Trastornos de la Conducta Alimentaria (TCA) de 11 horas (HP-TCA-11h), respecto a la recuperacion ponderal, evitar ingresos y disminuir estancias en HT. Metodo. Se realizo un estudio longitudinal y naturalistico que analizo las variables clinicas y socio-demograficas de los pacientes con AN que fueron dados de alta consecutivamente del HP-TCA-11h, durante los anos 2015-2016. Resultados. Se realizaron 77 altas. La edad media fue de 14.4 anos (DE: 1.62). La estancia media fue de 28.9 dias (DE: 18.5). La media del indice de masa corporal aumento significativamente al alta (17.2 frente a 17.9, p Conclusion. HP-TCA-11h ha demostrado ser un recurso eficaz como alternativa a la HT para adolescentes con AN moderada-grave. Este nuevo modelo tiene implicaciones coste-efectivas ya que es un recurso seguro y menos costoso que la HT. EnglishIntroduction. Inpatient Treatment (IT) is the treatment of choice for moderate or severely ill adolescents with Anorexia Nervosa (AN). Nevertheless, it is expensive, and the risk for relapse or readmissions is high. A less costly alternative to IT is Day Patient Treatment (DP), which may also help to avoid relapses and readmissions because facilitates transition from hospital to community treatment. Aim. To assess the effectiveness of the 11-hour DP program for Eating Disorders (DP-ED-11h), a new intensive DP treatment for adolescents with AN, with respect to weight recovery, avoidance of hospital admission and decrease of Length of Stay (LoS). Method. A longitudinal, naturalistic study was carried out analysing clinical and sociodemographic variables from 77 patients with AN who were consecutively discharged from DP-ED-11h, during years 2015-2016. Results. There were 77 discharges. The average age was 14.4 years old (SD: 1.62). The LoS at DP-ED-11h was 28.9 days (SD: 18.5). The mean body mass index increased significantly at discharge (17.2 vs. 17.9, p Conclusion. DP-ED-11h has shown to be an effective resource as an alternative to IT for adolescents with moderate to severe AN. This new model has cost-effectiveness implications as it is a safe resource and is less costly than IT.
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