Neese J B, Abraham I L, Buckwalter K C
University of North Carolina at Charlotte, College of Nursing and Health Professions, Department of Community Nursing 28223, USA.
Arch Psychiatr Nurs. 1999 Feb;13(1):30-40. doi: 10.1016/s0883-9417(99)80015-6.
Rural elders are an undeserved and vulnerable population with compromised access to health and human services leading to premature institutionalization. Even though elders living in rural areas have psychiatric illnesses that would prompt them to use mental health services, their use of these services remains low. This study developed predictive models of psychiatric hospitalization, use of mental health services, and use of crisis intervention by rural elders participating in an outreach case-management program. A combination of demographic, health status, and organizational variables were used in stepwise multiple regression. Being married and having supplemental insurance in addition to Medicare predicted 23% of the variance for utilization of psychiatric hospitalization. Only one variable, Medicaid, predicted 14% of the variance for use of mental health services. Type of caregiver, marital status, household composition, and Medicaid insurance accounted for 23% of the variance in utilization of crisis intervention by rural elders. Overall, the two variables that most likely predicted use of psychiatric mental health services were marital status and type of insurance.
农村老年人是一个未得到应有关注且易受伤害的群体，他们获得健康和人类服务的机会有限，这导致他们过早地被送进养老院。尽管生活在农村地区的老年人患有精神疾病，这会促使他们使用心理健康服务，但他们对这些服务的使用率仍然很低。本研究为参与外展个案管理项目的农村老年人建立了精神病住院、心理健康服务使用和危机干预使用的预测模型。在逐步多元回归中使用了人口统计学、健康状况和组织变量的组合。已婚且除医疗保险外还有补充保险，可预测精神病住院使用率方差的23%。只有一个变量，即医疗补助，可预测心理健康服务使用方差的14%。照顾者类型、婚姻状况、家庭构成和医疗补助保险占农村老年人危机干预使用率方差的23%。总体而言，最有可能预测精神病心理健康服务使用情况的两个变量是婚姻状况和保险类型。
