Queensland Centre for Health Data Services, The University of Queensland, St Lucia, Brisbane, Queensland 4072, Australia.
Br J Psychiatry. 2009 Dec;195(6):545-50. doi: 10.1192/bjp.bp.109.067082.
Most data on the quality of vascular care for individuals with psychiatric conditions come from countries without universal healthcare.
To investigate the treatment of people with psychosis admitted for ischaemic heart disease or stroke under universal healthcare.
A population-based study of administrative data comparing Canadians with and without a history of schizophrenia or related psychosis (n = 65,039).
Of 49 248 admissions for ischaemic heart disease, 1285 had a history of psychosis. Despite a higher 1-year mortality, they were less likely to receive guideline-consistent treatment: e.g. coronary artery bypass grafting (adjusted odds ratio (OR) = 0.35, 95% CI 0.25-0.48), beta-blockers (adjusted OR = 0.82, 95% CI 0.71-0.95) and statins (adjusted OR = 0.51, 95% CI 0.41-0.63). Of 15 791 admissions for stroke, 594 had a history of psychosis. Despite higher 1-year mortality rates, they were less likely to receive cerebrovascular arteriography or warfarin.
People with a history of psychosis do not receive equitable levels of vascular care under universal healthcare.
大多数关于精神疾病患者血管护理质量的数据来自没有全民医疗保健的国家。
调查在全民医疗保健下，患有精神病的人因缺血性心脏病或中风住院的治疗情况。
一项基于人群的行政数据研究，比较了有和没有精神分裂症或相关精神病病史的加拿大人（n=65039）。
在 49248 例缺血性心脏病住院患者中，有 1285 例有精神病病史。尽管 1 年死亡率较高，但他们接受指南一致治疗的可能性较低：例如，冠状动脉旁路移植术（调整后的优势比（OR）=0.35，95%置信区间 0.25-0.48）、β受体阻滞剂（调整后的 OR=0.82，95%置信区间 0.71-0.95）和他汀类药物（调整后的 OR=0.51，95%置信区间 0.41-0.63）。在 15791 例中风住院患者中，有 594 例有精神病病史。尽管 1 年死亡率较高，但他们接受脑血管造影或华法林治疗的可能性较低。
在全民医疗保健下，有精神病史的人没有得到平等的血管护理水平。
