在患有精神健康问题的患者中使用急诊室:概况,相关性和结果
Marie-Josée Fleury1,2, Zhirong Cao2, Guy Grenier2
1Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC H3A 1A1, Canada.
概括
患有心理健康问题的患者经常使用急诊室 (ED). 识别用户档案揭示了高风险群体需要更好的社区护理,以减少住院和死亡等不良结果.
科学领域:
- 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
- 紧急医疗 紧急医疗
背景情况:
- 患有精神健康 (MH) 问题的患者经常使用急诊室 (ED) 是一个公认的挑战.
- 了解这些患者中ED使用的不同模式对于有针对性的干预至关重要.
- 现有研究强调需要将ED使用概况与患者特征和健康结果联系起来.
研究的目的:
- 为了确定急诊室 (ED) 用户有心理健康 (MH) 问题的独特个人资料.
- 将这些个人资料与患者人口统计,门诊服务利用率以及随后的不良健康结果联系起来.
- 为特定的ED用户群体制定量身定制的干预措施提供信息.
主要方法:
- 隐性类别分析被用来识别ED用户个人资料在5年的队列 (2012-2017) 的11,682名患者在北克,加拿大.
- 多项逻辑回归分析了患者特征之间的关联,门诊服务的使用,并确定了ED用户配置文件.
- 考克斯回归模型评估了ED访问后12个月内不良结果的风险,包括住院和死亡.
主要成果:
- 出现了四个不同的ED用户配置文件:"MH服务访问"",重复ED用户"",高ED用户"和"非常高/反复高ED用户".
- 高和非常高的ED用户档案 (3和4) 显示了严重的疾病和高的ED使用,尽管接受了更多的门诊护理.
- 这些高使用者面临住院和死亡的风险增加,这表明未满足的需求和不理想的护理途径.
结论:
- 可以识别出患有精神健康 (MH) 疾病的频繁急诊室 (ED) 用户的特定配置文件.
- 高利用率的个人资料与严重的疾病和不良结果的风险增加有关,这表明有护理缺口.
- 建议包括对高风险群体进行强有力的社区治疗,对其他群体进行增强的初级保健,以改善结果.
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