Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
Health Aff (Millwood). 2011 Jul;30(7):1307-15. doi: 10.1377/hlthaff.2010.1084.
Mentally ill people may face barriers to receiving elective surgical procedures as a result of societal stigma and the cognitive, behavioral, and interpersonal deficits associated with mental illness. Using data from a cohort of elderly Medicare beneficiaries in 2007, we examined whether the mentally ill have less access than people without mental illness to several common procedures that are typically not for emergencies and are performed at the discretion of the provider and the patient. Results suggest that Medicare patients with mental illness are 30-70 percent less likely than others to receive these "referral-sensitive" surgical procedures. Those who did undergo an elective procedure generally experienced poorer outcomes both in the hospital and after discharge. Efforts to improve access to and outcomes of nonpsychiatric care for mentally ill patients are warranted.
精神疾病患者可能会因为社会污名和与精神疾病相关的认知、行为和人际缺陷而在接受选择性手术方面面临障碍。利用 2007 年一组老年医疗保险受益人的数据，我们研究了精神疾病患者是否比没有精神疾病的人获得几种常见程序的机会更少，这些程序通常不是紧急情况，并且由提供者和患者自行决定。结果表明，患有精神疾病的医疗保险患者接受这些“转诊敏感”手术的可能性比其他人低 30%至 70%。那些确实接受了选择性手术的患者，无论是在医院内还是出院后，一般都有更差的结果。有必要努力改善精神疾病患者获得非精神科护理的机会和改善其护理效果。
