Receipt of preventive medical care and medical screening for patients with mental illness: a comparative analysis
Receipt of preventive medical care and medical screening for patients with mental illness: a comparative analysis
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DOI：
10.1016/j.genhosppsych.2010.04.004
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发表时间：
2010-09-01
影响因子：
7
通讯作者：
Mitchell, Alex J.
中科院分区：
文献类型：
--
作者：
Lord, Oliver;Malone, Darren;Mitchell, Alex J.
背景：长期以来，人们一直关注向精神病患者提供预防和筛查服务。目的：我们的目的是检验有心理健康状况的患者所接受的预防性护理的质量是否与没有类似精神障碍的个体所接受的有所不同。我们的假设是，精神疾病患者将接受较低质量或较低频率的预防性护理。方法：回顾那些检查患有和不患有精神疾病的患者的护理质量的研究，并提取比较数据。我们希望通过只使用比较研究来确定是否存在由于精神疾病诊断(或密切相关因素)而导致的护理不平等。结果：我们确定了26项研究，这些研究考察了有或没有精神疾病的个人的预防性护理。从这些合格的研究中，记录了13个医疗保健领域的61个比较。这些措施包括乳房X光检查、宫颈涂片、疫苗接种、胆固醇筛查、生活方式咨询和结肠镜检查。27项比较显示，精神疾病患者的预防性医疗服务较差，但有10项建议优于预防性医疗服务，24项得出的结论不确定。在精神分裂症、骨质疏松筛查、血压监测、疫苗接种、乳房X光检查和胆固醇监测方面，较差的预防服务最为明显。结论：我们得出结论：有强有力的证据表明，精神疾病患者接受的预防和筛查服务质量往往较低，但有时优于没有类似精神障碍的人。必须做更多的工作，以提高精神疾病患者的医疗和预防护理质量。(C)2010 Elsevier Inc.保留所有权利。
Background: There has been long-standing concern about the delivery of preventive and screening services to patients with mental illness. Objective: We aimed to examine whether the quality of preventive care received by patients with mental health conditions differs from that received by individuals who have no comparable mental disorder. Our hypothesis was that patients with mental illness would be in receipt of lower quality or lower frequency of preventive care.Method: Studies that examined the quality of care in those with and without comorbid mental illness were reviewed and comparative data extracted. By using only comparative studies we hope to ascertain whether inequalities in care existed by virtue of psychiatric diagnoses (or closely affiliated factors).Results: We identified 26 studies that examined preventive care in individuals with vs. without psychiatric illness. From these eligible studies, 61 comparisons were documented across 13 health care domains. These included mammography, cervical smears, vaccinations, cholesterol screening, lifestyle counseling, colonoscopy. Twenty-seven comparisons revealed inferior preventive health care in those with mental illness, but 10 suggested superior preventive health care and 24 reached inconclusive findings. Inferior preventive care was most apparent in those with schizophrenia and in relation to osteoporosis screening, blood pressure monitoring, vaccinations, mammography and cholesterol monitoring.Conclusions: We conclude there is strong evidence to suggest that the quality of preventive and screening services received by patients with mental illness is often lower, but occasionally superior to that received by individuals who have no comparable mental disorder. More work must be done to improve the quality of medical and preventive care for individuals with mental illness. (C) 2010 Elsevier Inc. All rights reserved.