Mental Health Service Use Among Children and Youth in Ontario: Population-Based Trends Over Time
Mental Health Service Use Among Children and Youth in Ontario: Population-Based Trends Over Time
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DOI：
10.1177/0706743715621254
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发表时间：
2016-02-01
影响因子：
4
通讯作者：
Kurdyak, Paul
中科院分区：
文献类型：
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作者：
Gandhi, Sima;Chiu, Maria;Kurdyak, Paul
目的：加拿大儿童和青少年对精神卫生服务的使用知之甚少。我们的目的是研究生活在安大略的儿童和青少年在卫生保健系统不同部门使用精神卫生服务的时间趋势。我们进行了一项基于人群的、重复的年度精神卫生服务使用横断面研究，包括精神卫生和成瘾相关急诊（艾德）就诊、精神病住院、以及使用链接的卫生管理数据库进行的与精神健康有关的门诊医生就诊。受试者包括10至24岁的安大略居民。我们使用线性回归模型测试了2006年至2011年的时间趋势。结果：2006年至2011年，与心理健康相关的艾德就诊率和住院率的相对增长分别为32.5%和53.7%。焦虑症是艾德就诊的最常见原因，其绝对增加率为每1000人中有2.2人（P < 0.001），而情绪和情感障碍是住院的最常见原因，其绝对增加率为每1000人中有0.6人（P < 0.01）。整体相对增加率的门诊就诊率为15.8%，与家庭医生就诊（28.7每1000人，P = 0.01）中发现的最大的绝对增长。结论：随着时间的推移，在所有部门的儿童和青少年的精神卫生保健的使用正在增加，但似乎是在增加一个更大的速度在急性护理部门。需要进一步的研究来了解观察到的差异是否反映了获得门诊治疗的困难。
Objective: Little is known about mental health service use among Canadian children and youth. Our objective was to examine temporal trends in mental health service use across different sectors of the health care system among children and youth living in Ontario.Methods: We conducted a population-based, repeated annual cross-sectional study of mental health service use, including mental health-and addictions-related emergency department (ED) visits, psychiatric hospitalizations, and mental health-related outpatient physician visits using linked health administrative databases. Subjects included Ontario residents between 10 and 24 years of age. We tested temporal trends between 2006 and 2011 using linear regression models.Results: Between 2006 and 2011, the relative increase in rates of mental health-related ED visits and hospitalizations were 32.5% and 53.7%, respectively. The absolute increase in anxiety disorders, the most common reason for ED visits, was 2.2 per 1000 population (P < 0.001) while mood and affective disorders, the most common reason for hospitalizations, showed an increase of 0.6 per 1000 population (P < 0.01). The overall relative increase in rates of outpatient visits was 15.8%, with the largest absolute increase found among family physician visits (28.7 per 1000 population, P = 0.01).Conclusions: Mental health care use for children and youth is increasing over time in all sectors, but appears to be increasing at a greater rate in the acute care sector. Further research is required to understand whether the observed differences reflect difficulty with access to outpatient care.