1 Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.
2 Research and Evaluation Unit, Women's and Children's Hospital, Women's and Children's Health Network, North Adelaide, SA, Australia.
Aust N Z J Psychiatry. 2018 Oct;52(10):972-982. doi: 10.1177/0004867418760713. Epub 2018 Mar 2.
To identify the percentage of 4-17 year olds with mental disorders in Australia who attended health professionals for single or repeat visits to get help for emotional and behavioural problems during a 12-month period. To identify factors associated with single and repeat visits, and the average length of time between visits. To compare the number of parent-reported visits with visits recorded in the Medicare Benefits Schedule.
The study used data from the national survey of the mental health and wellbeing of 4-17 year olds conducted in 2013-2014 ( n = 6310). Participants were randomly selected from all 4 to 17 year olds in Australia. Information about visits was available from face-to-face interviews with parents, the Medicare Benefits Schedule and self-reports from 13 to 17 year olds. Mental disorders were assessed using the Diagnostic Interview Schedule for Children Version IV completed by parents.
Parents reported that 51.1% of 4-17 year olds with mental disorders had attended a health professional during the previous 12 months. However, 13.6% of these children had attended on only a single occasion, most commonly with a general practitioner. With the exception of occupational therapists, 2-4 visits was the most common number of repeat visits. Children with comorbid disorders and severe functional impairment and those aged 12-17 years were more likely to have repeat visits. Among those with linked Medicare Benefits Schedule data, more children were reported by parents to have attended Medicare Benefits Schedule-funded health professionals (47.9%) than were recorded in Medicare Benefits Schedule data (38.0%).
The typical number of visits to health professionals by children with mental disorders during a 12-month period is relatively small. Furthermore, parent-reports may overestimate the number of visits during this time. It seems unlikely that current patterns of attendance are of sufficient duration and frequency to allow full implementation of evidence-based treatment programmes for child and adolescent mental disorders.
确定澳大利亚 4-17 岁患有精神障碍的儿童中，在 12 个月内，有多少人因情绪和行为问题，单独或多次寻求卫生专业人员的帮助。确定与单次和多次就诊相关的因素，以及两次就诊之间的平均时间间隔。比较父母报告的就诊次数与医疗保险福利计划（Medicare Benefits Schedule）中记录的就诊次数。
本研究使用了 2013-2014 年全国范围内对 4-17 岁儿童心理健康和幸福感的调查数据（n=6310）。参与者是从澳大利亚所有 4-17 岁的儿童中随机抽取的。通过与父母的面对面访谈、医疗保险福利计划和 13-17 岁青少年的自我报告，可以获得就诊信息。使用家长完成的儿童诊断访谈表第四版（Diagnostic Interview Schedule for Children Version IV）评估精神障碍。
父母报告称，51.1%患有精神障碍的 4-17 岁儿童在过去 12 个月内曾就诊于卫生专业人员。然而，其中 13.6%的儿童仅就诊过一次，最常见的是全科医生。除了职业治疗师，2-4 次就诊是最常见的重复就诊次数。合并障碍、严重功能障碍的儿童和 12-17 岁的儿童更有可能重复就诊。在有医疗保险福利计划数据链接的儿童中，父母报告的就诊于医疗保险福利计划资助的卫生专业人员的儿童（47.9%）多于医疗保险福利计划数据记录的儿童（38.0%）。
在 12 个月内，患有精神障碍的儿童就诊于卫生专业人员的典型次数相对较少。此外，父母的报告可能会高估这段时间内的就诊次数。目前的就诊模式似乎不太可能持续足够的时间和频率，以充分实施针对儿童和青少年精神障碍的循证治疗方案。
