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政府补贴的心理健康服务在澳大利亚的养老院中未得到充分利用。

Government-subsidised mental health services are underused in Australian residential aged care facilities.

机构信息

Registry of Senior Australians, South Australian Health and Medical Research Institute Adelaide, SA 5001, Australia; and College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia.

Registry of Senior Australians, South Australian Health and Medical Research Institute Adelaide, SA 5001, Australia.

出版信息

Aust Health Rev. 2022 Aug;46(4):432-441. doi: 10.1071/AH22049.

Abstract

Objective To describe patterns of use of the available Government-subsidised mental health services among people living in Australian residential aged care facilities. Methods A retrospective population-based trend analysis was conducted, including all non-Indigenous people living in an Australian facility between 2012 and 2017. Adjusted incidence proportions and trends were estimated for four groups of mental health services. Results The use of Medicare-subsidised mental health services was very low overall. The proportion of residents who accessed primary care mental health services increased from 1.3% in 2012/2013 to 2.4% in 2016/2017, while psychiatry service use increased from 1.9 to 2.3%. Claims for clinical psychology increased from 0.18 to 0.26%, and claims for a registered psychologist, occupational therapist or social worker rose from 0.45 to 1.2%. People with dementia were less likely than people without dementia to access all services aside from psychiatry services. Conclusions Less than 3% of residents accessed funding subsidies for mental health services and people with dementia experienced pronounced barriers to service access. Mental health care is a pillar of the publicly-funded health system in Australia, and low use of these services among aged care residents indicates a need for organisational and policy changes to improve access.

摘要

目的

描述澳大利亚居住在养老院的人群对政府补贴的心理健康服务的使用模式。

方法

采用回顾性基于人群的趋势分析,包括 2012 年至 2017 年间居住在澳大利亚设施中的所有非土著人。对四组心理健康服务进行了调整后的发病率比例和趋势估计。

结果

总体而言,使用医疗保险补贴的心理健康服务的比例非常低。接受初级保健心理健康服务的居民比例从 2012/2013 年的 1.3%增加到 2016/2017 年的 2.4%,而精神病服务的使用从 1.9%增加到 2.3%。临床心理学的索赔从 0.18 增加到 0.26%,注册心理学家、职业治疗师或社会工作者的索赔从 0.45 增加到 1.2%。与没有痴呆症的人相比,痴呆症患者除了精神病服务之外,不太可能获得所有服务。

结论

不到 3%的居民获得了心理健康服务的资金补贴,痴呆症患者在服务获取方面面临明显的障碍。心理健康护理是澳大利亚公共资助卫生系统的支柱,居住在养老院的居民对这些服务的低利用率表明需要进行组织和政策变革以改善服务获取。

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