Gandhi Sima, Chiu Maria, Lam Kelvin, Cairney John C, Guttmann Astrid, Kurdyak Paul
Institute for Clinical Evaluative Sciences, Toronto, Ontario.
Institute for Clinical Evaluative Sciences, Toronto, Ontario McMaster University, Hamilton, Ontario.
Can J Psychiatry. 2016 Feb;61(2):119-24. doi: 10.1177/0706743715621254.
Little is known about mental health service use among Canadian children and youth. Our objective was to examine temporal trends in mental health service use across different sectors of the health care system among children and youth living in Ontario.
We conducted a population-based, repeated annual cross-sectional study of mental health service use, including mental health- and addictions-related emergency department (ED) visits, psychiatric hospitalizations, and mental health-related outpatient physician visits using linked health administrative databases. Subjects included Ontario residents between 10 and 24 years of age. We tested temporal trends between 2006 and 2011 using linear regression models.
Between 2006 and 2011, the relative increase in rates of mental health-related ED visits and hospitalizations were 32.5% and 53.7%, respectively. The absolute increase in anxiety disorders, the most common reason for ED visits, was 2.2 per 1000 population (P < 0.001) while mood and affective disorders, the most common reason for hospitalizations, showed an increase of 0.6 per 1000 population (P < 0.01). The overall relative increase in rates of outpatient visits was 15.8%, with the largest absolute increase found among family physician visits (28.7 per 1000 population, P = 0.01).
Mental health care use for children and youth is increasing over time in all sectors, but appears to be increasing at a greater rate in the acute care sector. Further research is required to understand whether the observed differences reflect difficulty with access to outpatient care.
对于加拿大儿童和青少年使用心理健康服务的情况,人们了解甚少。我们的目的是研究安大略省儿童和青少年在医疗保健系统不同部门使用心理健康服务的时间趋势。
我们开展了一项基于人群的年度重复横断面研究,以了解心理健康服务的使用情况,包括与心理健康和成瘾相关的急诊科就诊、精神病住院治疗以及使用关联的卫生行政数据库进行的心理健康相关门诊医生就诊。研究对象包括10至24岁的安大略省居民。我们使用线性回归模型测试了2006年至2011年期间的时间趋势。
2006年至2011年期间,与心理健康相关的急诊科就诊率和住院率的相对增幅分别为32.5%和53.7%。急诊科就诊最常见原因——焦虑症的绝对增幅为每千人口2.2例(P<0.001),而住院最常见原因——情绪和情感障碍的增幅为每千人口0.6例(P<0.01)。门诊就诊率的总体相对增幅为15.8%,其中家庭医生就诊的绝对增幅最大(每千人口28.7例,P=0.01)。
随着时间推移,儿童和青少年在各个部门使用心理健康服务的情况都在增加,但在急性护理部门的增长速度似乎更快。需要进一步研究以了解观察到的差异是否反映了门诊护理获取方面的困难。