在整个急诊室和替代环境中,重复在青年中利用精神病紧急服务
Rachel Oblath1,2, Annelle B Primm3, Alison Duncan1,2
1Boston University Chobanian and Avedisian School of Medicine, Boston.
Psychiatric services (Washington, D.C.)
|March 12, 2026
概括
超过四分之一的年轻人使用精神病紧急服务 (PES) 在180天内重复访问. 在急诊室 (ED) 访问后入院患者减少了重复访问,但在某些情况下预测重复ED使用.
科学领域:
- 儿科急救医学 儿科急救医学
- 儿童和青少年精神病学 儿童和青少年精神病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 年轻人反复使用精神病紧急服务 (PES) 是一个重大问题.
- 了解影响重复访问的因素对于改善护理连续性和资源分配至关重要.
- 之前的研究还没有完全阐明在不同环境中重复使用PES的预测因素.
研究的目的:
- 确定与重复使用精神病紧急服务 (PES) 相关的社会人口统计学和临床因素,无论是在急诊室 (ED) 还是青年中的其他环境.
- 检查具体结果,包括180天内任何重复访问,随后的ED访问和总重复访问.
- 为了告知有针对性的干预措施,以减少儿科人口中反复出现的精神病危机.
主要方法:
- 城市PES计划 (2017-2022) 电子医疗记录的回顾性图表审查.
- 包括18岁以下的新患者,无论是公共保险还是无保险.
- 使用二进制后勤回归和零膨胀波桑模型进行分析,以确定重复利用的预测因素.
主要成果:
- 这项研究包括了6,522名年轻人;超过25%的人在180天内重复访问.
- 青少年 (与7-12岁的儿童相比) 不太可能重复访问.
- 学校转诊与更少的重复访问有关;住院入院减少了重复访问,但预测了重复使用ED.
- 在ED遭遇后入院患者的入院与更少的重复访问和总重复访问有关.
结论:
- 在年轻人中重复使用PES是复杂的,受当地因素和先前干预措施的影响.
- 住院住院可能会减轻整体重复访问,但可以预测随后的ED使用.
- 建议积极主动地进行病例管理和护理导航,以确保获得心理健康护理的机会.
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