Prevalence, severity, and co-occurrence of chronic physical health problems of persons with serious mental illness
Prevalence, severity, and co-occurrence of chronic physical health problems of persons with serious mental illness
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DOI：
10.1176/appi.ps.55.11.1250
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发表时间：
2004-11-01
影响因子：
3.8
通讯作者：
Harding, CM
中科院分区：
文献类型：
--
作者：
Jones, DR;Macias, C;Harding, CM
目的：本研究检查了医疗补助索赔表，以确定患病率，严重程度和共同发生的身体疾病的严重精神疾病的人（N=147）的代表性样本。研究方法：健康问题的代表性，在研究样本中，通过与同一州内参加医疗补助的严重精神疾病患者的较大样本进行比较。然后将标准化的年度费用分配给医疗补助索赔诊断，并将个人健康问题的严重程度衡量为诊断条件的估计治疗费用之和。结果如下：74%的研究样本（N=109）被诊断出至少一种慢性健康问题，50%（N=73）被诊断出两种或两种以上的慢性健康问题。在接受调查的14种慢性健康状况中，慢性肺部疾病是最普遍的（发病率为31%），也是最常见的共病。慢性肺病患者的平均年治疗费用仅次于传染病患者（8 277美元）。此外，在其他八个诊断类别中，50%或更多的参与者患有慢性肺部疾病。回归分析确定了年龄、肥胖和。物质使用障碍作为个人健康问题严重程度的重要预测因素。结论：在制定绩效标准或成本预期时，对身体健康进行风险调整是必不可少的。进行心理健康治疗将患有慢性健康问题的人排除在心理健康服务评估之外，限制了研究结果的普遍性，并可能促进不适合许多患有严重心理疾病的人的干预措施。
Objectives: This study examined Medicaid claims forms to determine the prevalence, severity, and co-occurrence of physical illness within a representative sample of persons with serious mental illness (N=147). Methods: Representativeness of health problems, in the study sample was established through comparison with a larger sample of persons with serious mental illness enrolled in Medicaid within the same state. Standardized annual costs were then assigned to Medicaid claims diagnoses, and individual health problem severity was measured as the sum of estimated treatment costs for diagnosed conditions. Results: Seventy-four percent of the study sample (N=109) had been given a diagnosis of at least one chronic health problem, And 50 percent (N=73) had been given a diagnosis of two or more chronic health problems. Of the 14 chronic health conditions surveyed, chronic pulmonary illness was the most prevalent (31 percent incidence) and the most comorbid. Persons with chronic pulmonary illness were second only to those with infectious diseases in average annual cost of treatment ($8,277). Also, 50 percent or more of participants in eight other diagnostic categories had chronic Pulmonary illness. A regression analysis identified age, obesity, and. substance use disorders as significant predictors of individual health Problem severity. Conclusions: Risk adjustment for physical health is essential when setting performance standards or cost expectations. for mental health treatment. Excluding persons with chronic health problems from mental health service evaluations restricts generalizability of research findings and may promote interventions that are inappropriate for many persons with serious mental illness.