安大略省远程精神病学的实施和利用:基于人群的研究。

Implementation and Utilisation of Telepsychiatry in Ontario: A Population-Based Study.

机构信息

1 Centre for Addiction and Mental Health, Toronto, Ontario.

2 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario.

出版信息

Can J Psychiatry. 2017 Oct;62(10):716-725. doi: 10.1177/0706743717711171. Epub 2017 May 25.

Abstract

OBJECTIVE

Rural areas in Ontario have fewer psychiatrists, making access to specialist mental health care challenging. Our objective was to characterise psychiatrists delivering and patients receiving telepsychiatry in Ontario and to determine the number of patients who accessed a psychiatrist via telepsychiatry following discharge from psychiatric hospitalisation.

METHOD

We conducted a serial panel study to evaluate the characteristics of psychiatrists providing telepsychiatry from April 2007 to March 2013. In addition, we conducted a cross-sectional study for fiscal year 2012-2013 to examine telepsychiatry patient characteristics and create an in-need patient cohort of individuals with a recent psychiatric hospitalisation that assessed if they had follow-up with a psychiatrist in person or through telepsychiatry within 1 year of discharge.

RESULTS

In fiscal year 2012-2013, a total of 3801 people had 5635 telepsychiatry visits, and 7% ( n = 138) of Ontario psychiatrists provided telepsychiatry. Of the 48,381 people identified as in need of psychiatric care, 60% saw a local psychiatrist, 39% saw no psychiatrist, and less than 1% saw a psychiatrist through telepsychiatry only or telepsychiatry in addition to local psychiatry within a year. Three northern regions had more than 50% of in-need patients fail to access psychiatry within 1 year.

CONCLUSIONS

Currently, relatively few patients and psychiatrists use telepsychiatry. In addition, patients scarcely access telepsychiatry for posthospitalisation follow-up. This study, which serves as a preliminary baseline for telepsychiatry in Ontario, demonstrates that telepsychiatry has not evolved systematically to address need and highlights the importance of system-level planning when implementing telepsychiatry to optimise access to care.

摘要

目的

安大略省的农村地区精神科医生较少,因此获得专业精神卫生保健服务具有挑战性。我们的目的是描述在安大略省提供远程精神病学服务的精神科医生和接受远程精神病学服务的患者,并确定在精神病院出院后通过远程精神病学就诊的患者人数。

方法

我们进行了一项连续的面板研究,以评估 2007 年 4 月至 2013 年 3 月期间提供远程精神病学服务的精神科医生的特征。此外,我们还进行了 2012-2013 财年的横断面研究,以检查远程精神病学患者的特征,并创建一个最近有精神病院住院经历的需要治疗的患者队列,评估他们在出院后一年内是否通过亲自或远程精神病学与精神科医生进行了随访。

结果

在 2012-2013 财年,共有 3801 人进行了 5635 次远程精神病学就诊,7%(n=138)的安大略省精神科医生提供远程精神病学服务。在确定需要精神科治疗的 48381 人中,60%的人看了当地的精神科医生,39%的人没有看精神科医生,不到 1%的人在一年内仅通过远程精神病学或远程精神病学加当地精神病学就诊。三个北部地区有超过 50%的需要治疗的患者在一年内无法获得精神科治疗。

结论

目前,只有相对较少的患者和精神科医生使用远程精神病学。此外,患者很少通过远程精神病学进行出院后的随访。这项研究为安大略省的远程精神病学提供了初步的基线,表明远程精神病学尚未系统地发展以满足需求,并强调在实施远程精神病学以优化获得护理的机会时,需要进行系统层面的规划。

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