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[与医学专科医生和全科医生医疗保健消费数据相比的心理健康护理利用数据分析]

[Analysis of mental health care utilization data in comparison with medical-specialist and general practitioner health care consumption data].

作者信息

van Os J, Mulder W

出版信息

Tijdschr Psychiatr. 2021;63(1):39-47.

Abstract

Quantification of population-level socioeconomic-demographic factors impacting onset and course of health care consumption can help health care commissioning and public health planning.
AIM: To analyse associations between mental health care, medical-specialist care and general practitioner (GP) care with regional socioeconomic-demographic factors. Two cost parameters were examined: (i) absolute costs; and (ii) relative costs, defined as the proportion of PC3-level costs attributable to outliers (defined as costs above the 80th percentile - as a proxy for care intensity).
METHOD: Analysis of Vektis data over the period 2014-2017 in the age range of 18-65 years.
RESULTS: Mental health care cost variation was for 28% reducible to (younger) age, urbanicity, PC3-level ethnic density and PC3-level socioeconomic-demographic factors. Variation in medical-specialist care and GP care costs were reducible principally to (older) age. Costs attributable to outliers ranged from 34% for GP care to 55% for mental health care. Socioeconomic-demographic factors explained a substantial part of the variation in the PC3-level proportion of outlier costs for mental health care (31%), medical-specialist care (43%) and GP-care (33%).
CONCLUSION: Analysis of the degree and pattern of socioeconomic-demographic factors impacting mental health care can inform both public mental health planning and mental health care commissioning. Tijdschrift voor psychiatrie 63(2021)1, 39-47.

摘要

对影响医疗保健消费起始和过程的人群层面社会经济人口因素进行量化,有助于医疗保健委托和公共卫生规划。

目的

分析心理健康护理、医学专科护理和全科医生(GP)护理与区域社会经济人口因素之间的关联。研究了两个成本参数:(i)绝对成本;(ii)相对成本,定义为PC3级别成本中归因于异常值(定义为高于第80百分位数的成本——作为护理强度的代理)的比例。

方法

分析2014 - 2017年期间18 - 65岁年龄段的Vektis数据。

结果

心理健康护理成本差异中,28%可归因于(较年轻)年龄、城市化程度、PC3级别种族密度和PC3级别社会经济人口因素。医学专科护理和全科医生护理成本差异主要可归因于(较年长)年龄。归因于异常值的成本范围从全科医生护理的34%到心理健康护理的55%。社会经济人口因素解释了心理健康护理(31%)、医学专科护理(43%)和全科医生护理(33%)的PC3级别异常值成本比例差异的很大一部分。

结论

对影响心理健康护理的社会经济人口因素的程度和模式进行分析,可为公共心理健康规划和心理健康护理委托提供参考。《精神病学杂志》63(2021)1, 39 - 47。

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