Hobbs Knutson Katherine, Meyer Mark J, Thakrar Nisha, Stein Bradley D
1 Kraft Center for Community Health, Partners Healthcare, Boston, MA, USA.
2 Georgetown University, Washington, DC, USA.
Clin Pediatr (Phila). 2018 Jan;57(1):5-10. doi: 10.1177/0009922817733740. Epub 2017 Nov 1.
Many children are treated for mental health disorders in primary care settings. The system of care (SOC) provides a framework for collaboration among pediatric mental health providers, but it is unclear if youth treated for mental health disorders in primary care receive such coordination. At the South Boston Community Health Center from September /2012 to August 2013 for 74 individuals ≤18 years, the odds of contact with SOC agencies (mental health, education, child protective services, juvenile justice and developmental disabilities) were compared for mental health treatment in primary versus specialty care. The odds of SOC contact within primary care were lower compared to specialty care (OR = 0.43, 95% CI = 0.29-0.66), specifically for mental health (OR = 0.54, 95% CI = 0.25-1.2), education (OR = 0.12, 95% CI = 0.050-0.28), and child protective services (OR = 0.64, 95% CI = 0.22-1.9). As care coordination may improve health outcomes, increased support and education for care coordination specific to youth treated for mental health disorders in primary care settings may be warranted.
许多儿童在初级保健机构接受心理健康障碍治疗。护理系统(SOC)为儿科心理健康服务提供者之间的协作提供了一个框架,但尚不清楚在初级保健机构接受心理健康障碍治疗的青少年是否能得到这种协调。在2012年9月至2013年8月期间,在南波士顿社区健康中心对74名18岁及以下个体进行研究,比较了在初级保健与专科保健中接受心理健康治疗的个体与SOC机构(心理健康、教育、儿童保护服务、少年司法和发育障碍)接触的几率。与专科保健相比,初级保健中与SOC接触的几率较低(比值比=0.43,95%置信区间=0.29-0.66),特别是在心理健康方面(比值比=0.54,95%置信区间=0.25-1.2)、教育方面(比值比=0.12,95%置信区间=0.05-0.28)和儿童保护服务方面(比值比=0.64,95%置信区间=0.22-1.9)。由于护理协调可能改善健康结果,因此可能有必要为在初级保健机构接受心理健康障碍治疗的青少年提供更多针对护理协调的支持和教育。