Health Services Research and Development, Ann Arbor Department of Veterans Affairs Health System, MI, USA.
Psychiatr Serv. 2011 Apr;62(4):422-5. doi: 10.1176/ps.62.4.pss6204_0422.
The aim of this study was to determine whether implementation of primary care mental health services is associated with differences in specialty mental health clinic use within the Veterans Health Administration (VHA).
The authors compared over a one-year period the new use of specialty mental health clinics and psychiatric diagnosis patterns among patients of 118 primary care facilities that offered integrated mental health care with 142 facilities without this service, with adjustment for other facility characteristics.
Patients at both types of primary care facilities (those with integrated mental health care and those without) initiated specialty mental health treatment at similar rates (5.6% versus 5.8%) and averaged similar total specialty mental health clinic visits (7.0 versus 6.3). There were no significant differences in diagnosis patterns.
Initial national implementation of mental health care in primary care within the VHA was not associated with substantial differences in new specialty mental health clinic use or diagnostic case mix among primary care patients.
本研究旨在确定在退伍军人事务部（VHA）中，初级保健心理健康服务的实施是否与专业心理健康诊所使用的差异相关。
作者在一年的时间内比较了提供综合心理健康服务的 118 个初级保健设施的患者与 142 个无此类服务的设施的新使用专业心理健康诊所和精神科诊断模式，同时调整了其他设施特征。
两种类型的初级保健设施（提供综合心理健康服务和不提供此类服务的设施）的患者开始专业心理健康治疗的比例相似（5.6%与 5.8%），平均专业心理健康诊所就诊次数也相似（7.0 次与 6.3 次）。诊断模式没有显著差异。
VHA 中在初级保健中初步实施心理健康护理，与初级保健患者新的专业心理健康诊所使用或诊断病例组合方面没有明显差异。
