Disparities in Treatment of Older Adults with Suicide Risk in the Emergency Department.
Disparities in Treatment of Older Adults with Suicide Risk in the Emergency Department.
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DOI：
10.1111/jgs.15011
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发表时间：
2017-10
影响因子：
6.3
通讯作者：
Betz ME
中科院分区：
文献类型：
--
作者：
Arias SA;Boudreaux ED;Segal DL;Miller I;Camargo CA Jr;Betz ME
我们描述了老年（≥60岁）与年轻（<60岁）成人急诊科（ED）自杀风险患者的特征和接受的治疗。回顾图表审查。一个对自杀风险进行全面筛查的急诊室。符合条件的图表包括在过去2周内筛查出自杀意念（SI）阳性和/或在过去6个月内有自杀企图（SA）的成年人（≥18岁）的随机样本。访问日期为2014年5月至2016年9月。共审查了800张图表，并对老年人进行了抽样调查。在抽样调查的200名老年人中，与年轻人（n=600）相比，老年人较少的主诉涉及精神行为（53%对70%）或自残行为（26%对36%）。尽管与年轻人（79%）相比，更多的老年人（93%）有当前SI的记录，但与年轻人（23%）相比，过去两周报告SA的老年人（17%）较少。在那些自杀筛查呈阳性的出院者中，不到一半的老年人在访问期间接受了心理健康评估（42%,95%CI 34-52），而符合相同标准的年轻人中有66% （95%CI 61-70）接受了心理健康评估。同样，目前患有SI/SA的老年患者接受转诊资源的人数少于年轻患者（34%;95%CI 26-43; 60%; 95%CI 55-65）。与相似的年轻人相比，出院的有自杀倾向的老年患者接受心理健康评估的人数明显减少。这些发现强调了改善对有自杀风险的老年人的治疗的一个重要领域。
We described characteristics and treatment received for older (≥60 years) versus younger (<60 years) adult emergency department (ED) patients with suicide risk. Retrospective chart review. An ED with universal screening for suicide risk. Eligible charts included a random sample of adults (≥18 years) who screened positive for suicidal ideation (SI) in past 2 weeks and/or a suicide attempt (SA) within the past 6 months. Visit dates were from 5/2014 to 9/2016. A total of 800 charts were reviewed, with oversampling of older adults. Of the 200 older adults sampled, fewer older adults compared to younger adults (n=600) had a chief complaint involving psychiatric behavior (53% vs. 70%) or self-harm behavior (26% vs. 36%). Although more older adults (93%) had documentation of current SI compared to younger adults (79%), fewer older adults (17%) reported SA in the past two weeks compared to younger adults (23%). Of those with a positive suicide screen who were discharged home, less than half of older adults received a mental health evaluation during their visit (42%, 95%CI 34–52) compared to 66% (95%CI 61–70) of younger adults who met the same criteria. Similarly, fewer older than younger adult patients with current SI/SA received referral resources (34%; 95%CI 26–43; versus 60%; 95%CI 55–65). Significantly fewer suicidal older adult patients who were discharged home received a mental health evaluation when compared to similar younger adults. These findings highlight an important area for improvement in the treatment of older adults at risk for suicide.
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DOI：
10.1080/13811118.2016.1158679
发表时间：
2016-10
期刊：
Archives of suicide research : official journal of the International Academy for Suicide Research
影响因子：
--
作者：
Knorr AC;Tull MT;Anestis MD;Dixon-Gordon KL;Bennett MF;Gratz KL
通讯作者：
Gratz KL
影响因子：
120.7
作者：
Unuetzer, Juergen;Park, Mijung
通讯作者：
Park, Mijung
影响因子：
2.2
作者：
Boudreaux, Edwin D.;Miller, Ivan;Camargo, Carlos A., Jr.
通讯作者：
Camargo, Carlos A., Jr.
影响因子：
3.1
作者：
Da Cruz, D.;Pearson, A.;Kapur, N.
通讯作者：
Kapur, N.
DOI：
10.1027/0227-5910.29.2.73
发表时间：
2008-01-01
影响因子：
3
作者：
Larkin, Gregory Luke;Smith, Rebecca P.;Beautrais, Annette L.
通讯作者：
Beautrais, Annette L.