Quality of General Medical Care Among Patients With Serious Mental Illness: Does Colocation of Services Matter?
Quality of General Medical Care Among Patients With Serious Mental Illness: Does Colocation of Services Matter?
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DOI：
10.1176/ps.62.8.pss6208_0922
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发表时间：
2011-08-01
影响因子：
3.8
通讯作者：
Yano, Elizabeth M.
中科院分区：
文献类型：
--
作者：
Kilbourne, Amy M.;Pirraglia, Paul A.;Yano, Elizabeth M.
目的：本研究基于一个具有全国代表性的样本，确定接受退伍军人事务部(VA)精神健康计划的严重精神疾病患者与没有联合诊所的患者相比，是否更有可能得到足够的医疗服务。方法：这项研究纳入了所有在2006-2007财年被诊断患有严重精神疾病的退伍军人管理局患者，他们也是退伍军人管理局外部同行审查计划(EPRP)2007财年的一部分，他们接受了退伍军人管理局机构(N=107家机构)的护理，组织数据来自退伍军人精神健康计划调查(N=7514)。EPRP包括常见护理过程(糖尿病并发症的足部和视网膜检查；结直肠健康、乳腺癌和酗酒筛查；烟草咨询)和结果(高血压、糖尿病、血糖和血脂控制)的患者水平图表审查质量指标。结果：107个心理健康项目中有10个(10%)的诊所设在同一地点。在调整了组织和患者水平的因素后，分析表明，来自托管诊所的患者比没有托管的患者更有可能接受足部检查(OR=1.87，p
Objective: This study was conducted to determine whether patients with serious mental illness receiving care in Veterans Affairs (VA) mental health programs with colocated general medical clinics were more likely to receive adequate medical care than patients in programs without colocated clinics based on a nationally representative sample. Methods: The study included all VA patients with diagnoses of serious mental illness in fiscal year (FY) 2006-2007 who were also part of the VA's External Peer Review Program (EPRP) FY 2007 random sample and who received care from VA facilities (N=107 facilities) with organizational data from the VA Mental Health Program Survey (N=7,514).EPRP included patient-level chart review quality indicators for common processes of care (foot and retinal examinations for diabetes complications; screens for colorectal health, breast cancer, and alcohol misuse; and tobacco counseling) and outcomes (hypertension, diabetes blood sugar, and lipid control). Results: Ten out of 107 (10%) mental health programs had colocated medical clinics. After adjustment for organizational and patient-level factors, analyses showed that patients from colocated clinics compared with those without colocation were more likely to receive foot exams (OR=1.87, p