魁北克精神分裂症和物质使用障碍患者中急诊部门的高使用人群。
High users of emergency departments in Quebec among patients with both schizophrenia and a substance use disorder.
作者信息
Ngamini-Ngui André, Fleury Marie-Josée, Moisan Jocelyne, Grégoire Jean-Pierre, Lesage Alain, Vanasse Alain
机构信息
Dr. Ngamini-Ngui and Dr. Fleury are with the Centre de Réadaptation en Dépendance de Montréal, Institut Universitaire, Montreal, Quebec, Canada (e-mail:
出版信息
Psychiatr Serv. 2014 Nov 1;65(11):1389-91. doi: 10.1176/appi.ps.201300474. Epub 2014 Oct 31.
OBJECTIVE
The study assessed factors associated over time with high use of emergency departments by patients in Quebec who had schizophrenia and a co-occurring substance use disorder.
METHODS
The cohort study included 2,921 patients who received a diagnosis of schizophrenia in 2006 and had at least one emergency department visit during fiscal year 2006-2007. Generalized estimating equations were used to estimate predictors of high use of emergency departments over time.
RESULTS
After adjustment for all covariates, predictors of high use over time were as follows: living in either a university medical region (OR=2.10) or a peripheral medical region (OR=2.10), frequent hospitalization (OR=1.16), and greater number of psychiatric (OR=1.64) or physical comorbidities (OR=1.23).
CONCLUSIONS
Because high use of emergency departments is a strong indicator of poor care continuity, identified associated factors could help develop and offer new programs to be deployed in the community to better support these patients with greater needs.
目的
本研究评估了魁北克患有精神分裂症且同时患有物质使用障碍的患者长期频繁使用急诊科的相关因素。
方法
这项队列研究纳入了2921名在2006年被诊断为精神分裂症且在2006 - 2007财政年度至少有一次急诊科就诊经历的患者。使用广义估计方程来估计长期频繁使用急诊科的预测因素。
结果
在对所有协变量进行调整后，长期频繁使用急诊科的预测因素如下：居住在大学医疗区域（比值比=2.10）或周边医疗区域（比值比=2.10）、频繁住院（比值比=1.16）以及更多的精神科（比值比=1.64）或躯体合并症（比值比=1.23）。
结论
由于频繁使用急诊科是护理连续性差的一个有力指标，确定的相关因素有助于制定并提供新的项目，以便在社区中实施，从而更好地支持这些有更多需求的患者。
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