退伍军人事务医疗设施中精神卫生人员配备水平与初级保健-精神卫生整合水平在抑郁症护理提供方面的关联。
Association Between Mental Health Staffing Level and Primary Care-Mental Health Integration Level on Provision of Depression Care in Veteran's Affairs Medical Facilities.
作者信息
Cooper Denise C, Helfrich Christian D, Thielke Stephen M, Trivedi Ranak B, Nelson Karin M, Reiber Gayle E, Eugenio Evercita C, Beaver Kristine, Nugent-Carney Julie, Fan Vincent S
机构信息
Health Services Research & Development (HSR&D), Veteran Affairs (VA) Puget Sound Health Care System, 1660 Columbian Way, Seattle, WA, 98108, USA.
Department of Health Services, University of Washington, Seattle, WA, USA.
出版信息
Adm Policy Ment Health. 2018 Jan;45(1):131-141. doi: 10.1007/s10488-016-0775-9.
We examined the association of mental health staffing and the utilization of primary care/mental health integration (PCMHI) with facility-level variations in adequacy of psychotherapy and antidepressants received by Veterans with new, recurrent, and chronic depression. Greater likelihood of adequate psychotherapy was associated with increased (1) PCMHI utilization by recurrent depression patients (AOR 1.02; 95% CI 1.00, 1.03); and (2) staffing for recurrent (AOR 1.03; 95% CI 1.01, 1.06) and chronic (AOR 1.02; 95% CI 1.00, 1.03) depression patients (p < 0.05). No effects were found for antidepressants. Mental health staffing and PCMHI utilization explained only a small amount of the variance in the adequacy of depression care.
我们研究了心理健康人员配备以及初级保健/心理健康整合（PCMHI）的利用情况与退伍军人新发性、复发性和慢性抑郁症患者接受心理治疗和抗抑郁药物充足性的机构层面差异之间的关联。充分心理治疗的可能性增加与以下因素相关：（1）复发性抑郁症患者对PCMHI的利用率提高（调整后比值比[AOR]为1.02；95%置信区间[CI]为1.00，1.03）；以及（2）复发性（AOR为1.03；95%CI为1.01，1.06）和慢性（AOR为1.02；95%CI为1.00，1.03）抑郁症患者的人员配备（p<0.05）。未发现抗抑郁药物有此类影响。心理健康人员配备和PCMHI的利用仅解释了抑郁症护理充足性方面的一小部分差异。
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