在全面的危机系统中,在30天内患者流动和危机服务的再利用
Milos Tomovic1, Margaret E Balfour1, Ted Cho1
1School of Medicine, Georgetown University, Washington, D.C. (Tomovic); Connections Health Solutions and Department of Psychiatry, University of Arizona, Tucson (Balfour); Department of Pediatrics, University of California San Francisco, San Francisco (Cho); Center for Health Information and Research (CHIR), College of Health Solutions, Arizona State University, Tempe (Prathap, Harootunian); Social Innovation Ventures, Lewes, Delaware (Mehreen, Ostrovsky); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Goldman).
了解危机服务利用是关键,因为这些系统正在扩大. 种族,无家可归和特定条件等因素会影响30天内服务的重复使用,从而为更好的危机系统设计提供信息.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 心理健康服务 心理健康服务
背景情况:
- 美国正在大幅扩大危机服务,但对最佳危机系统设计的研究是有限的.
- 了解患者流动和影响服务重复使用的因素对于有效的危机护理至关重要.
- 本研究探讨了在综合危机系统中的服务利用模式和再利用驱动因素.
研究的目的:
- 描述患者通过一个成熟的危机服务系统流动.
- 在30天内确定与服务再利用相关的人口,临床和运营因素.
主要方法:
- 一项采用Medicaid索赔数据的横截面研究,通过移动危机,专业危机设施,急诊室和住院服务来绘制患者的旅程.
- 将索赔数据与电子健康记录合并为一组在危机响应中心接受护理的患者.
- 使用概括估计方程来确定与30天服务重复利用相关的因素.
主要成果:
- 大多数危机事件 (57.4%) 是由移动危机或专门设施发起的,而不是紧急部门.
- 大多数发作 (63.3%) 并没有随之而来的服务再利用.
- 再利用的增加与黑人种族,无家可归,兴奋剂使用,精神病和特定服务途径 (移动危机启动,住院完成) 有关.
- 减少再利用与抑郁症,创伤和非自愿的法律地位有关;大多数非自愿的案件都被解决为自愿的状态.
结论:
- 危机系统有效地管理精神病紧急情况,并可以将患者从更密集的重症监护中转移.
- 确定影响30天再利用的因素对于优化危机系统设计和实施至关重要.
- 数据驱动的洞察力可以提高心理健康危机应对服务的效率和有效性.
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