Dropout from outpatient mental health care in the United States.
Dropout from outpatient mental health care in the United States.
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从美国门诊心理健康护理中退出。
DOI：
10.1176/ps.2009.60.7.898
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
Kessler,RonaldC
中科院分区：
文献类型：
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作者：
Olfson,Mark;Mojtabai,Ramin;Sampson,NancyA;Hwang,Irving;Druss,Benjamin;Wang,PhilipS;Wells,KennethB;Pincus,HaroldAlan;Kessler,RonaldC
虽然心理健康治疗的辍学是常见的，但辍学的原因和预测因素知之甚少。本研究探讨了模式和预测的心理健康治疗辍学在全国代表性sample.MethodsData是从全国科摩罗调查复制，全国代表性的家庭调查。在访谈前12个月内接受过心理健康治疗的受访者（N= 1，664）被问及辍学情况，辍学的定义是在提供者希望他们停止之前退出治疗。交叉制表和离散时间生存分析被用来确定predictors. ResultsAbout五分之一（22%）的患者过早退出治疗。辍学率最高的是在普通医疗部门接受的治疗（32%），最低的是在精神科医生接受的治疗（15%）。在人类服务部门（20%）和非精神科医生精神卫生专业人员（19%）的患者中，脱落率处于中间水平。超过70%的脱落发生在第一次或第二次访视后。心理健康保险与低辍学率相关（比值比=。6，95%置信区间=。4-. 9）。精神科合并症与辍学趋势相关。几个病人的特点差异预测辍学跨治疗部门和早期和后期阶段的treatment.ConclusionsRoughly五分之一的成年人在心理健康治疗退出之前完成推荐的疗程。辍学在一般医疗部门最常见，各治疗部门因患者特征而异。可能需要针对高风险患者和辍学率较高的部门采取干预措施，以减少提前终止治疗的患者比例。（精神病学服务60：898-907，2009）
ObjectiveAlthough mental health treatment dropout is common, pat-terns and predictors of dropout are poorly understood. This study explored patterns and predictors of mental health treatment dropout in a nationally representative sample.MethodsData were from the National Comorbidity Survey Replication, a nationally representative household survey. Respondents who had received mental health treatment in the 12 months before the interview (N= 1,664) were asked about dropout, which was defined as quitting treatment before the provider wanted them to stop. Cross-tabulation and discrete-time survival analyses were used to identify predictors.ResultsApproximately one-fifth (22%) of patients quit treatment prematurely. The highest dropout rate was from treatment received in the general medical sector (32%), and the lowest was from treatment received by psychiatrists (15%). Dropout rates were intermediate from treatment in the human services sector (20%) and among patients seen by nonpsychiatrist mental health professionals (19%). Over 70% of all dropout occurred after the first or second visits. Mental health insurance was associated with low odds of dropout (odds ratio=. 6, 95% confidence interval=. 4–. 9). Psychiatric comorbidity was associated with a trend toward dropout. Several patient characteristics differentially predicted dropout across treatment sectors and in early and later phases of treatment.ConclusionsRoughly onefifth of adults in mental health treatment dropped out before completing the recommended course of treatment. Dropout was most common in the general medical sector and varied by patient characteristics across treatment sectors. Interventions focused on high-risk patients and sectors that have higher dropout rates will likely be required to reduce the large proportion of patients who prematurely terminate treatment.(Psychiatric Services 60: 898–907, 2009)