Department of Collective Health, School of Medical Sciences, University of Campinas, St. Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-887, Brazil.
Health Services and Population Research Department, Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
BMC Health Serv Res. 2021 Oct 15;21(1):1095. doi: 10.1186/s12913-021-07127-3.
Although matrix support seeks to promote integrating Primary Care with specialized mental health services in Brazil, little is known about the quantitative impact of this strategy on sharing cases between different levels of care. The aim of this study was to investigate the prevalence and factors associated with Primary Care registration of the mental health needs of patients treated at outpatient specialized services in a medium-sized city in Brazil with recent implementation of matrix support.
This is a document-based cross-sectional study conducted through an analysis of 1198 patients' medical records. Crude and adjusted associations with the outcome were explored using logistic regression.
The prevalence of cases registered in Primary Care was 40% (n = 479). Evidence was found for associations between the outcome and the patients being over 30 years old, and referral by emergency or hospital services. There was conversely an inverse association between the outcome and status as a patient from the Outpatient Clinic or from the Psychosocial Care Center for psychoactive substance misuse.
Even with the provision of mechanisms for network integration, such as matrix support, our results suggest that more groundwork is necessary to ensure that sharing cases between Primary Care and specialized services is effective.
尽管矩阵支持旨在促进巴西将初级保健与专业精神卫生服务相结合,但对于该策略对不同层次护理之间病例共享的定量影响知之甚少。本研究旨在调查在巴西一个中等城市实施矩阵支持后,专门门诊服务治疗的患者的精神卫生需求在初级保健中登记的流行情况及其相关因素。
这是一项基于文件的横断面研究,通过分析 1198 名患者的病历进行。使用逻辑回归探索了与结果相关的粗关联和调整关联。
在初级保健中登记的病例比例为 40%(n=479)。研究结果表明,病例与患者年龄超过 30 岁以及由急诊或医院服务转诊之间存在关联。而与门诊或精神卫生保健中心因精神活性物质滥用接受治疗的患者身份呈反比关系。
即使提供了网络整合机制,如矩阵支持,我们的结果表明,还需要做更多的基础工作,以确保初级保健和专业服务之间的病例共享是有效的。