Centre for Mental Health Research, The Australian National University, Canberra, Australia.
Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia.
PLoS One. 2018 Jun 1;13(6):e0198400. doi: 10.1371/journal.pone.0198400. eCollection 2018.
General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.
全科医学在澳大利亚医疗保健系统中具有重要作用,可提供医疗服务并有效管理慢性健康问题。然而,患有严重精神疾病的人在获得服务方面面临挑战。本文旨在探讨与接受 2 型糖尿病(一种在全科医学中管理的常见身体健康问题)治疗的人群相比,普通人群和严重精神障碍人群获得全科医生治疗的途径。“改善医疗保健评估和护理(BEACH)”计划为澳大利亚全科医生活动提供了最全面和客观的衡量标准。本研究利用 BEACH 数据,在 2006 年至 2016 年的 10 年期间,比较了抑郁、焦虑、双相情感障碍、精神分裂症和 2 型糖尿病的全科医生就诊情况。分析结果显示,与焦虑症相比,抑郁症患者就诊更为频繁,而双相情感障碍患者中女性就诊比例高于男性。就诊次数与患者年龄之间的关系与每种疾病相关的生命周期和死亡率特征密切相关。这些发现突出了与严重精神疾病患者获得初级保健相关的具体挑战,并提出了关注重点,以提高这些患者获得和利用卫生系统的能力。