患有严重精神疾病和物质使用障碍的患者对医疗服务的使用情况。
Use of health care services by patients with co-occurring severe mental illness and substance use disorders.
作者信息
Kêdoté Marius N, Brousselle Astrid, Champagne François
机构信息
Université de Montréal, Public Health.
Groupe de Recherche Interdisciplinaire en Santé (GRIS); Université de Montréal, Department of Health Administration.
出版信息
Ment Health Subst Use. 2008 Sep 19;1(3):216-227. doi: 10.1080/17523280802274886.
BACKGROUND
To better respond to the health care needs of people with co-occurring mental illness and substance use disorders, it is vital to understand their itinerary through the health care system.
AIM
To describe the characteristics of service utilization among patients with co-occurring disorders in a large urban area.
METHOD
We used a sample ( = 5467) constituted from administrative and clinical databases. Those identified as having substance use disorders and psychoses were followed over 12 months with respect to their utilization of medical services. A descriptive analysis of the data and a two-step cluster analysis were undertaken.
RESULTS
Our analyses revealed a relatively high utilization of emergency services, outpatient clinics, private practices and hospitalization among patients with co-occurring disorders of severe mental illness and substance use. The two-step cluster analysis produced four heterogeneous groups in terms of service utilization.
CONCLUSIONS
This study demonstrates the need to develop strategies for organizing health care and services that are adapted to various sites of service utilization and to diverse profiles of patients with co-occurring mental illness and substance use disorders.
背景
为了更好地满足同时患有精神疾病和物质使用障碍的人群的医疗保健需求，了解他们在医疗保健系统中的就医过程至关重要。
目的
描述大城市地区同时患有多种疾病的患者的服务利用特征。
方法
我们使用了一个由行政和临床数据库组成的样本（n = 5467）。对那些被确定患有物质使用障碍和精神病的患者，就其医疗服务利用情况进行了为期12个月的跟踪。对数据进行了描述性分析和两步聚类分析。
结果
我们的分析显示，患有严重精神疾病和物质使用障碍的患者对急诊服务、门诊诊所、私人诊所和住院治疗的利用率相对较高。两步聚类分析在服务利用方面产生了四个不同的组。
结论
本研究表明，有必要制定策略来组织医疗保健和服务，使其适应不同的服务利用场所以及同时患有精神疾病和物质使用障碍的不同患者群体。
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