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全科医生小组的特征及其在精神卫生保健中的参与情况。

GP group profiles and involvement in mental health care.

机构信息

Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre (DMHUIRC), Montréal, Québec, Canada.

出版信息

J Eval Clin Pract. 2012 Apr;18(2):396-403. doi: 10.1111/j.1365-2753.2010.01597.x. Epub 2010 Nov 30.

Abstract

RATIONALE AND OBJECTIVES

Mental health is one of the leading causes of morbidity worldwide. Its impact in terms of cost and loss of productivity is considerable. Improving the efficiency of mental health care system has thus been a high priority for decision makers. In the context of current reforms that privilege the reinforcement of primary mental health care and integration of services, this article brings new lights on the role of general practitioners (GPs) in managing mental health, and shared-care initiatives developed to deal with more complex cases. The study presents a typology of GPs providing mental health care, by identifying clusters of GP profiles associated with the management of patients with common or serious mental disorders (CMD or SMD).

METHODS

GPs in Quebec (n = 398) were surveyed on their practice, and socio-demographic data were collected.

RESULTS

Cluster analysis generated five GP profiles, including three that were closely tied to mental health care (labelled, respectively: group practice GPs, traditional pro-active GPs and collaborative-minded GPs), and two not very implicated in mental health (named: diversified and low-implicated GPs, and money-making GPs).

CONCLUSION

The study confirmed the central role played by GPs in the treatment of patients with CMD and their relative lack of involvement in the care of patients with SMD. Study results support current efforts to strengthen collaboration among primary care providers and mental health specialists, reinforce GP training, and favour multi-modal clinical and collaborative strategies in mental health care.

摘要

背景与目的

精神健康是全球导致发病的主要原因之一。其在成本和生产力损失方面的影响相当大。因此,提高精神卫生保健系统的效率一直是决策者的首要任务。在当前优先加强初级精神卫生保健和整合服务的改革背景下,本文就全科医生(GP)在管理精神健康方面的作用以及为处理更复杂病例而开发的共同护理举措提供了新的视角。该研究通过确定与常见或严重精神障碍(CMD 或 SMD)患者管理相关的 GP 特征聚类,对提供精神卫生保健的 GP 进行了分类,提出了 GP 提供精神卫生保健的一种类型学。

方法

对魁北克的全科医生(n = 398)进行了实践和社会人口学数据调查。

结果

聚类分析生成了五个 GP 特征聚类,其中三个与精神卫生保健密切相关(分别命名为:团体执业 GP、传统积极主动 GP 和合作思维 GP),另外两个与精神卫生保健关系不大(分别命名为:多样化和低介入 GP 和赚钱 GP)。

结论

研究证实了 GP 在治疗 CMD 患者方面的核心作用,以及他们在 SMD 患者护理方面相对缺乏参与。研究结果支持当前加强初级保健提供者和精神卫生专家之间合作、加强 GP 培训以及支持精神卫生保健中多模式临床和合作策略的努力。

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