Impact of Mobile Crisis Services on Emergency Department Use Among Youths With Behavioral Health Service Needs
Impact of Mobile Crisis Services on Emergency Department Use Among Youths With Behavioral Health Service Needs
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DOI：
10.1176/appi.ps.201800450
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发表时间：
2019-10-01
影响因子：
3.8
通讯作者：
Plant, Robert
中科院分区：
文献类型：
--
作者：
Fendrich, Michael;Ives, Melissa;Plant, Robert
目的：年轻人正在使用急诊室（ED）进行创纪录的行为健康服务，尽管ED是提供服务的次优设置。在这篇文章中，作者评估了在康涅狄格州实施的移动的危机服务干预措施，目的是检查干预措施是否与需要服务的人减少行为健康艾德使用有关。2，532名使用移动的危机服务的青年和3名比较样本，在同一财政年度使用行为健康艾德服务（但不是移动的危机服务）的961名青年。建立倾向评分以平衡两组，并使用结果分析来检查随后的艾德使用情况（任何行为健康艾德入院和行为健康艾德入院的数量）。结果：合并优势比为0.75（95%置信区间[CI] = 0.66-0.84）表明，接受移动的危机服务的青少年与接受移动危机服务的青少年相比，对比样本中的年轻人。行为健康艾德就诊次数的连续结果的可比结果产生了0.78（95%CI = 0.71-0.87）的发病风险比。结论：使用比较组，作者提供的证据表明，以社区为基础的移动的危机服务，如移动的危机，减少艾德使用的青少年行为健康服务的需求。需要在其他年份和地点进行复制。尽管如此，根据目前艾德使用的趋势，这些结果是非常有希望的。
Objective: Youths are using emergency departments (EDs) for behavioral health services in record numbers, even though EDs are suboptimal settings for service delivery. In this article, the authors evaluated a mobile crisis service intervention implemented in Connecticut with the aim of examining whether the intervention was associated with reduced behavioral health ED use among those in need of services.Methods: The authors examined two cohorts of youths: 2,532 youths who used mobile crisis services and a comparison sample of 3,961 youths who used behavioral health ED services (but not mobile crisis services) during the same fiscal year. Propensity scores were created to balance the two groups, and outcome analyses were used to examine subsequent ED use (any behavioral health ED admissions and number of behavioral health ED admissions) in an 18-month follow-up period.Results: A pooled odds ratio of 0.75 (95% confidence interval [CI] = 0.66-0.84) indicated that youths who received mobile crisis services had a significant reduction in odds of a subsequent behavioral health ED visit compared with youths in the comparison sample. The comparable result for the continuous outcome of number of behavioral health ED visits yielded an incidence risk ratio of 0.78 (95% CI = 0.71-0.87).Conclusions: Using comparison groups, the authors provided evidence suggesting that community-based mobile crisis services, such as Mobile Crisis, reduce ED use among youths with behavioral health service needs. Replication in other years and locations is needed. Nevertheless, these results are quite promising in light of current trends in ED use.