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哪些人有未得到满足的心理健康服务需求,他们在获得医疗保健方面还面临哪些其他障碍?来自澳大利亚和加拿大的调查结果。

Who experiences unmet need for mental health services and what other barriers to accessing health care do they face? Findings from Australia and Canada.

机构信息

Australian Institute of Tropical Health and Medicine, James Cook University, Queensland, New South Wales, Australia.

Bureau of Health Information, Chatswood, Sydney, New South Wales, Australia.

出版信息

Int J Health Plann Manage. 2019 Apr;34(2):761-772. doi: 10.1002/hpm.2733. Epub 2019 Jan 18.

Abstract

PURPOSE

To examine factors associated with unmet need for mental health services and links with barriers to access to care more broadly.

METHODOLOGY

The Commonwealth Fund International Health Policy Surveys from 2013 and 2016 were used to explore factors associated with unmet need for adults who experienced emotional distress for 1320 respondents in Australia and 2284 in Canada.

FINDINGS

Over one in five adults in Australia (21%) and in Canada (25%) experienced emotional distress, just over half said they received professional help (51% in Australia, 59% in Canada). The majority of those who did not get help indicated did not want to see a professional (37% in Australia, 30% in Canada). For those who did seek help, the factors associated with not receiving care included lower income, higher out-of-pocket health care costs, and poorer health. When compared with people with met needs, those with unmet needs for mental health services were more likely to also experience affordability, medication, and trust-related access barriers (AOR range 2.41 to 7.49 for the two countries, P < 0.01).

CONCLUSION

Including unmet needs for mental health services as part of regular reporting on access to care may bring attention to access barriers for people with mental health conditions.

摘要

目的

研究与心理健康服务未满足需求相关的因素,并探讨这些因素与更广泛的获得医疗服务障碍之间的联系。

方法

利用 2013 年和 2016 年英联邦基金国际卫生政策调查,对澳大利亚 1320 名和加拿大 2284 名经历情绪困扰的成年人进行了未满足需求相关因素的研究。

结果

澳大利亚(21%)和加拿大(25%)有超过五分之一的成年人经历情绪困扰,超过一半的人表示他们寻求过专业帮助(澳大利亚 51%,加拿大 59%)。大多数没有寻求帮助的人表示不想看专业人士(澳大利亚 37%,加拿大 30%)。对于那些寻求帮助的人来说,未获得治疗的相关因素包括收入较低、自付医疗费用较高和健康状况较差。与满足需求的人相比,心理健康服务未满足需求的人更有可能还面临可负担性、药物治疗和信任相关的获得医疗服务障碍(两国的比值比范围为 2.41 至 7.49,P 值均<0.01)。

结论

将心理健康服务的未满足需求纳入常规的获得医疗服务报告中,可能会引起人们对精神健康人群获得医疗服务障碍的关注。

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