Kowalewski Karolina, McLennan John D, McGrath Patrick J
University of Calgary, Calgary, Alberta.
J Can Acad Child Adolesc Psychiatry. 2011 May;20(2):112-9.
THE OBJECTIVES OF THIS STUDY WERE TO: 1) describe wait times at agencies providing child and adolescent mental health services (CAMHS) in Canada; and 2) determine whether agency and waiting list characteristics are associated with wait times for different clinical priority levels.
A web-based survey was distributed to 379 agencies providing CAMHS in Canada. The survey contained questions about agency characteristics, waiting list characteristics and agency wait times. Pearson's correlations were used to determine the bivariate relationship between agency and waiting list characteristics and wait times.
The response rate was 30.6% (n=116). Only 8.6% of agencies reported no waiting lists for their programs or services. Estimated mean wait times for initial assessment decreased with increasing levels of clinical priority. However, the ranges of wait times at each clinical priority level were substantial. In addition, only 31.4% of agencies reported being "mostly" or "always" able to meet the Canadian Psychiatric Association's wait time benchmark for scheduled care for psychiatric services. Wait times were positively correlated with size of the waiting list for those considered at lower clinical priority.
The findings confirm concerns about the prevalence of wait times for CAMHS in Canada, and also note marked variability. Though shorter wait times for higher priority children and youth is appropriate, current practice does not meet proposed standards of care as they relate to wait times. Future research should determine the impact of service reform efforts on reducing wait times for children with differing clinical priority levels.
本研究的目的是:1)描述加拿大提供儿童和青少年心理健康服务(CAMHS)机构的等待时间;2)确定机构和等候名单特征是否与不同临床优先级别的等待时间相关。
向加拿大379家提供CAMHS的机构开展了一项基于网络的调查。该调查包含有关机构特征、等候名单特征和机构等待时间的问题。使用Pearson相关性分析来确定机构和等候名单特征与等待时间之间的双变量关系。
回复率为30.6%(n = 116)。只有8.6%的机构报告其项目或服务没有等候名单。初始评估的估计平均等待时间随着临床优先级的提高而减少。然而,每个临床优先级别的等待时间范围都很大。此外,只有31.4%的机构报告“大部分”或“总是”能够达到加拿大精神病学协会关于精神科服务预约护理等待时间的基准。对于临床优先级较低的人群,等待时间与等候名单的规模呈正相关。
研究结果证实了对加拿大CAMHS等待时间普遍存在的担忧,同时也指出了显著的变异性。虽然为更高优先级的儿童和青少年缩短等待时间是合适的,但目前的做法并未达到与等待时间相关的建议护理标准。未来的研究应确定服务改革努力对减少不同临床优先级儿童等待时间的影响。