Castillejos M C, Martín-Pérez C, Mayoral-Cleries F, Bordallo-Aragón A, Sepúlveda-Muñoz J, Moreno-Küstner B
Departament of Personality, Assessment and Psychological Treatment, University of Malaga, Campus Teatinos, Malaga, Spain.
Andalusian Group of Psychosocial Research (GAP), Malaga, Spain.
BMC Fam Pract. 2018 Nov 28;19(1):180. doi: 10.1186/s12875-018-0866-7.
Patients with psychiatric disorders have more physical problems than other patients, so their follow-up by the general practitioner is particularly important for them.
We aimed to elaborate a multilevel explanatory model of general practitioner (GP) visits made by patients with schizophrenia and related disorders (SRD). An observational, cross-sectional study was conducted from January 1, 2008 to July 1, 2011, in the area of the Clinical Management Unit of Mental Health (CMU-MH) of the Regional Hospital of Malaga (Spain). The eligible population consisted of all patients with SRD in contact with a GP residing in the study area. Our dependent variable was total number GP visits. The independent variables were: 1) patient variables (sociodemographic and clinical variables); 2) primary care centre (PCC) variables. We performed descriptive analysis, bivariate analysis and multilevel regression.
Four hundred ninety four patients were included. Mean annual number of GP visits was 4.1. Female sex, living in a socioeconomically deprived area, a diagnosis of schizoaffective disorder and contact with a GP who had a more active approach to mental health issues were associated with a higher number of visits whilst being single and good communication between the PCC and mental health teams were associated with a lower number of GP visits.
Number of GP visits was not just associated with patient factors, but also with organisational and the involvement of health professionals, for example GPs with an active approach to mental health issues.
患有精神疾病的患者比其他患者有更多的身体问题,因此全科医生对他们的随访对他们来说尤为重要。
我们旨在构建一个关于精神分裂症及相关障碍(SRD)患者全科医生(GP)就诊的多层次解释模型。2008年1月1日至2011年7月1日,在西班牙马拉加地区医院心理健康临床管理单元(CMU-MH)区域进行了一项观察性横断面研究。符合条件的人群包括居住在研究区域内与全科医生有接触的所有SRD患者。我们的因变量是全科医生就诊的总数。自变量为:1)患者变量(社会人口统计学和临床变量);2)基层医疗中心(PCC)变量。我们进行了描述性分析、双变量分析和多层次回归分析。
共纳入494名患者。全科医生就诊的年均次数为4.1次。女性、生活在社会经济贫困地区、被诊断为精神分裂症伴情感障碍以及与对心理健康问题采取更积极态度的全科医生接触,与就诊次数较多相关,而单身以及基层医疗中心与心理健康团队之间良好的沟通则与全科医生就诊次数较少相关。
全科医生就诊次数不仅与患者因素有关,还与组织因素以及卫生专业人员的参与有关,例如对心理健康问题采取积极态度的全科医生。