参与协作护理实施研究的双相情感障碍患者急诊科使用情况的相关因素

Correlates of Emergency Department Use by Individuals With Bipolar Disorder Enrolled in a Collaborative Care Implementation Study.

作者信息

Waxmonsky Jeanette, Verchinina Lilia, Kim Hyungjin Myra, Lai Zongshan, Eisenberg Daniel, Kyle Julia T, Nord Kristina M, Rementer Jenny H, Goodrich David E, Bauer Mark S, Thomas Marshall R, Kilbourne Amy M

机构信息

Dr. Waxmonsky is with the Department of Family Medicine and Dr. Thomas is with the Department of Psychiatry, University of Colorado School of Medicine, Aurora. Dr. Waxmonsky is also with the Office of Healthcare Transformation, Jefferson Center for Mental Health, Wheat Ridge, Colorado. Dr. Thomas is also with Colorado Access, Denver, where Ms. Rementer is affiliated. Dr. Verchinina, Dr. Kim, Mr. Lai, Ms. Kyle, Ms. Nord, Dr. Goodrich, and Dr. Kilbourne are with the Center for Clinical Management Research, Ann Arbor U.S. Department of Veterans Affairs (VA) Healthcare System, Ann Arbor, Michigan. Dr. Kim is also with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Mr. Lai, Ms. Kyle, Ms. Nord, Dr. Goodrich, and Dr. Kilbourne are also with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor. Dr. Eisenberg is with the Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor. Dr. Bauer is with the Center for Healthcare Organization and Implementation Research, Boston VA Healthcare System, Jamaica Plain, Massachusetts, and with the Department of Psychiatry, Harvard Medical School, Boston. Send correspondence to Dr. Kilbourne (e-mail:

出版信息

Psychiatr Serv. 2016 Nov 1;67(11):1265-1268. doi: 10.1176/appi.ps.201500347. Epub 2016 Jun 1.

DOI:10.1176/appi.ps.201500347

PMID:27247174

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5089922/

Abstract

OBJECTIVE

The study assessed correlates of emergency department use among participants in a collaborative care program for bipolar disorder.

METHODS

Community-based clinics from two states implemented Life Goals-Collaborative Care (LG-CC), an evidence-based model that includes self-management sessions and care management contacts. Logistic regression determined participant factors associated with emergency department use between six and 12 months after LG-CC implementation.

RESULTS

Of 219 participants with baseline and 12-month data, 24% reported at least one emergency department visit. Participants with a recent homelessness history (odds ratio [OR]=3.76, p=.01) or five or more care management contacts (OR=2.62, p=.05) had a higher probability of visiting an emergency department, after the analyses were adjusted for demographic and clinical factors, including physical health score and hospitalization history.

CONCLUSIONS

Participants in a collaborative care program who had a history of homelessness were more likely to use the emergency department, suggesting a greater need for more intensive care coordination.

摘要

目的

本研究评估了双相情感障碍协作护理项目参与者中急诊科使用情况的相关因素。

方法

来自两个州的社区诊所实施了生活目标协作护理（LG-CC），这是一种基于证据的模式，包括自我管理课程和护理管理联系。逻辑回归确定了与LG-CC实施后6至12个月内急诊科使用情况相关的参与者因素。

结果

在219名有基线和12个月数据的参与者中，24%报告至少有一次急诊科就诊。在对人口统计学和临床因素（包括身体健康评分和住院史）进行分析调整后，近期有过无家可归史的参与者（优势比[OR]=3.76，p=0.01）或有五次或更多护理管理联系的参与者（OR=2.62，p=0.05）去急诊科就诊的可能性更高。