Schmidt Eric M, Behar Simone, Barrera Alinne, Cordova Matthew, Beckum Leonard
Center for Innovation to Implementation (Ci2i), HSR&D, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA, 94025, USA.
Center for Primary Care and Outcomes Research/Center for Health Policy, Stanford University, 117 Encina Commons, Stanford, CA, 94305, USA.
J Behav Health Serv Res. 2018 Jul;45(3):370-388. doi: 10.1007/s11414-017-9570-y.
This study investigated geographic variation in potentially preventable medical outcomes that might be used to monitor access to high-quality medical care in the behavioral health population. Analyzing public and non-public data sources from California on adults admitted between 2009 and 2011 to all non-federal licensed medical inpatient (N = 6,603,146) or emergency department units (N = 21,011,958) revealed that 33.6% of nearly 1 million potentially preventable hospitalizations and 9.8% of 1.5 million potentially preventable emergency department visits were made by people with mental or substance use disorder diagnoses. Across California counties or county groups (N = 36), a higher preventable hospitalization rate in the behavioral health population was associated with higher poverty, higher primary care safety net utilization, and fewer mental health providers. Although further validation is required, rates of potentially preventable encounters, particularly hospitalizations, may be useful measures of access to high-quality care in the behavioral health population.
本研究调查了潜在可预防医疗结果的地理差异，这些差异可用于监测行为健康人群获得高质量医疗服务的情况。分析来自加利福尼亚州2009年至2011年间所有非联邦许可的医疗住院患者（N = 6,603,146）或急诊科（N = 21,011,958）的成人公共和非公共数据源发现，近100万例潜在可预防住院病例中的33.6%以及150万例潜在可预防急诊就诊病例中的9.8%是由患有精神或物质使用障碍诊断的人造成的。在加利福尼亚州的各个县或县组（N = 36）中，行为健康人群中较高的可预防住院率与较高的贫困率、较高的初级保健安全网利用率以及较少的心理健康服务提供者有关。尽管需要进一步验证，但潜在可预防就诊率，尤其是住院率，可能是衡量行为健康人群获得高质量医疗服务的有用指标。
