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纵向紧急关爱精神病学作为服务不足患者的独特接入点。

Longitudinal Urgent Care Psychiatry as a Unique Access Point for Underserved Patients.

机构信息

Department of Psychiatry, Brigham and Women's Hospital, Boston (Kroll, Wrenn, Grimaldi, Campbell, Raynor, Dawson, Irwin, Pires, Giacalone, Tuohy, Fromson, Gitlin); Department of Psychiatry, Harvard Medical School, Boston (Kroll, Grimaldi, Raynor, Dawson, Giacalone, Fromson, Wolfe, Gitlin); Department of Psychiatry, Newton-Wellesley Hospital, Boston (Wolfe).

出版信息

Psychiatr Serv. 2019 Sep 1;70(9):837-839. doi: 10.1176/appi.ps.201900043. Epub 2019 May 14.

DOI:10.1176/appi.ps.201900043
PMID:31084294
Abstract

OBJECTIVE

The authors sought to determine whether a walk-in psychiatry model with longitudinal follow-up capability could improve access for patients who traditionally miss appointments.

METHODS

An urgent care clinic that offers treatment exclusively on a walk-in basis was opened within an adult psychiatry practice to accommodate patients who missed prior scheduled appointments. Electronic health records for patients who received an initial psychiatry evaluation at the practice during a 6-month period (N=355) were reviewed retrospectively to track the clinic's productivity and patient demographic characteristics.

RESULTS

Eighty patients (23%) accessed their initial psychiatry encounters through the walk-in clinic. Medicaid recipients (odds ratio [OR]=1.89, 95% confidence interval [CI]=1.10-3.24) and individuals without a college degree (OR=1.86, 95% CI=1.04-3.32) were more likely than patients with other insurance carriers and those with a college degree, respectively, to access care through a walk-in encounter versus a scheduled appointment.

CONCLUSIONS

Longitudinal walk-in psychiatry services can feasibly be offered through the longitudinal urgent care psychiatry model. This model may serve as a unique access point for patients from historically underserved groups.

摘要

目的

作者旨在确定是否可以通过提供具有纵向随访能力的随到随诊精神病学模式来改善传统上错过预约的患者的就诊机会。

方法

在成人精神病学实践中开设了一个仅提供随到随诊服务的紧急护理诊所,以满足那些错过先前预约的患者的需求。回顾性审查了在该实践中接受 6 个月期间首次精神病学评估的患者的电子健康记录,以跟踪诊所的生产力和患者人口统计学特征。

结果

80 名患者(23%)通过随到随诊诊所获得了他们的初始精神病学就诊。医疗补助计划(OR=1.89,95%置信区间[CI]=1.10-3.24)和没有大学学历的患者(OR=1.86,95%CI=1.04-3.32)比其他保险计划的患者和具有大学学历的患者更有可能通过随到随诊而不是预约获得就诊机会。

结论

通过纵向紧急护理精神病学模式可以提供可行的纵向随到随诊精神病学服务。这种模式可能是为历史上服务不足的群体提供的独特就诊途径。

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