Differences in HIV care between patients with and without severe mental illness.
Differences in HIV care between patients with and without severe mental illness.
复制标题
患有和不患有严重精神疾病的患者之间的艾滋病毒护理差异。
DOI：
10.1176/ps.2007.58.5.681
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Kanouse,David
中科院分区：
文献类型：
--
作者：
Fremont,AllenM;Young,AlexanderS;Chinman,Matthew;Pantoja,Philip;Morton,Sally;Koegel,Paul;Sullivan,Greer;Kanouse,David
ObjectiveThis study explored how HIV care differs for infected per-sons with and without severe mental illness.MethodsData were obtained through interviews with and chart review of 295 patients with severe mental illness and HIV from public mental health agencies in Los Angeles County and New York City. Data were compared with data from 1,294 HIV patients without severe mental illness from a separate national probability sample. Measures were difficulty obtaining care, whether patients recommend their HIV care provider, hospital problem score, functional health status, and disability days.ResultsIn Los Angeles, HIV patients with severe mental illness were more likely than those without severe mental illness to have difficulty obtaining care (p<. 001); to not recommend their provider (10% versus 5%, p=. 007); and to have problematic hospital care (p=. 001), poor health status (p=. 001), and more disability days (p<. 001). In New York City, HIV patients with severe mental illness were more likely than patients without severe mental illness to have difficulty obtaining care (p=. 002) and not recommend their provider (p=. 02). The relationship between severe mental illness and health status in Los Angeles and access in New York City became insignificant after adjustment for sociodemographic factors, drug use, and CD4 cell count. Further adjustment for higher case management rates among HIV patients with severe mental illness reduced disparities only in the West.ConclusionsPatients with severe mental illness experienced more problems with HIV care than patients without severe mental illness, although high case management rates for patients with severe mental illness may have offset some problems.(Psychiatric Services 58: 681–688, 2007)
