Mental health care provision in community health centers and hospital emergency department utilization.
Mental health care provision in community health centers and hospital emergency department utilization.
复制标题
社区卫生中心和医院急诊室的精神卫生保健服务。
DOI：
10.1111/1475-6773.14283
复制
发表时间：
2024
影响因子：
3.4
通讯作者：
Cole,MeganB
中科院分区：
文献类型：
--
作者：
Carey,Kathleen;Cole,MeganB
ObjectivesTo examine whether community health centers（CHCs）are effective in offset mental health emergency department（艾德）visits.Data Sources and Study SettingThe HRSA Uniform Data System and the HCUP State艾德Databases for佛罗里达patients during 2012-2019.Study DesignWe identified CHC-year-specific service areas using patient origin zip code.然后，我们估计面板数据模型的数量艾德心理健康访问人均在CHC的服务区。模型测量CHC心理健康利用的访问次数，独特的病人，和强度（每名患者的访问）。主要发现CHC心理健康利用在2012-2019年期间增加了约100%。CHC精神卫生服务的增加与艾德精神卫生利用率的小幅下降有关。每年增加1000例CHC精神卫生保健就诊（5%）与艾德精神卫生保健就诊减少0.44%（p= 0.153）相关，增加1000例CHC精神卫生保健患者（15%）与艾德精神卫生保健就诊减少1.9%（p= 0.123）相关。每例患者增加1个年度的心理健康访问与16%的艾德精神卫生保健访问（p= 0.011）。促进社区卫生中心和当地医院之间服务协调的政策可能会加速这种效果。
ObjectivesTo examine whether community health centers (CHCs) are effective in offsetting mental health emergency department (ED) visits.Data Sources and Study SettingThe HRSA Uniform Data System and the HCUP State ED Databases for Florida patients during 2012–2019.Study DesignWe identified CHC‐year‐specific service areas using patient origin zip codes. We then estimated panel data models for number of ED mental health visits per capita in a CHC's service area. Models measured CHC mental health utilization as number of visits, unique patients, and intensity (visits per patient).Principal FindingsCHC mental health utilization increased approximately 100% during 2012–2019. Increased CHC mental health provision was associated with small reductions in ED mental health utilization. An annual increase of 1000 CHC mental health care visits (5%) was associated with 0.44% fewer ED mental health care visits (p= 0.153), and an increase of 1000 CHC mental health care patients (15%) with 1.9% fewer ED mental health care visits (p= 0.123). An increase of 1 annual mental health visit per patient was associated with 16% fewer ED mental health care visits (p= 0.011).ConclusionsResults suggest that mental health provision in CHCs may reduce reliance on hospital EDs, albeit minimally. Policies that promote alignment of services between CHCs and local hospitals may accelerate this effect.