Sara Grant, Arumuganathan Myu, Chen Wendy, Wu Fred, Currow David, Large Matthew, Mulder Cornelis, Ramanuj Parashar Pravin, Burgess Philip M
InforMH, System Information and Analytics Branch, NSW Ministry of Health, North Ryde, New South Wales, Australia
Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2019 Nov 19;9(11):e033588. doi: 10.1136/bmjopen-2019-033588.
Health systems must move from recognition to action if we are to address premature mortality in people with mental illness. Population data registers are an essential tool for planning and monitoring improvement efforts. The Mental Health Living Longer (MHLL) programme establishes a population-wide data linkage to support research translation and service reform in New South Wales (NSW), Australia.
A total of 8.6 million people who have had contact with NSW public and private health services between July 2001 and June 2018 are currently included in the study. Data include more than 120 million linked records from NSW data collections covering public and private hospital care, emergency departments, ambulance, community mental health services, cancer notifications and care, and death registrations. Linkage is occurring with population-wide breast and cervical cancer screening programmes. Data will be updated 6 monthly.
The cohort includes 970 145 people who have received mental healthcare: 79% have received community mental healthcare, 35% a general hospital admission with a primary mental health diagnosis and 25% have received specialist mental health inpatient care. The most frequent pattern of care is receipt of community mental healthcare only (50%). The median age of the mental health cohort is 34 years, and three-quarters are younger than 53 years. Eleven per cent of the mental health cohort had died during the observation period. Their median age at death was 69 years, which was younger than the median age at death for people accessing other health services.
The MHLL programme will examine (i) all-cause mortality, (ii) suicide, (iii) cancer mortality and (iv) medical mortality. Within each theme, the programme will quantify the problem in mental health service users compared with the NSW population, describe the people most affected, describe the care received, identify predictors of premature mortality, and identify variation and opportunities for change.
如果我们要解决精神疾病患者的过早死亡问题，卫生系统必须从认识阶段转向行动阶段。人口数据登记册是规划和监测改进工作的重要工具。“心理健康延年益寿”（MHLL）项目建立了全人群数据链接，以支持澳大利亚新南威尔士州（NSW）的研究转化和服务改革。
本研究目前纳入了2001年7月至2018年6月期间与新南威尔士州公共和私人卫生服务机构有过接触的共计860万人。数据包括来自新南威尔士州数据收集的1.2亿多条链接记录，涵盖公共和私立医院护理、急诊科、救护车、社区心理健康服务、癌症通报与护理以及死亡登记。正在与全人群乳腺癌和宫颈癌筛查项目进行数据链接。数据将每6个月更新一次。
该队列包括970145名接受过心理保健的人：79%接受过社区心理保健，35%因主要心理健康诊断而入住综合医院，25%接受过专科心理健康住院护理。最常见的护理模式是仅接受社区心理保健（50%）。心理健康队列的中位年龄为34岁，四分之三的人年龄小于53岁。在观察期内，心理健康队列中有十分之一的人死亡。他们的中位死亡年龄为69岁，低于使用其他卫生服务的人群的中位死亡年龄。
“心理健康延年益寿”项目将研究（i）全因死亡率，（ii）自杀率，（iii）癌症死亡率和（iv）医疗死亡率。在每个主题中，该项目将量化心理健康服务使用者与新南威尔士州人群相比的问题，描述受影响最严重的人群，描述所接受的护理，确定过早死亡的预测因素，并确定差异和变革机会。
