Clinical and Population Health Research PhD Program, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, USA.
Department of Population and Quantitative Health Sciences, Albert Sherman Center, University of Massachusetts Chan Medical School, 368 Plantation Street, MB, 01605, Worcester, USA.
BMC Health Serv Res. 2022 Jul 26;22(1):952. doi: 10.1186/s12913-022-08353-z.
The objective of this study is to describe age-related patterns of outpatient healthcare utilization in youth and young adults with mental health disorders.
We used the IBM MarketScan Commercial Database to identify 359,413 youth and young adults (12-27 years) with a mental health disorder continuously enrolled in private health insurance in 2018. Exploratory analysis was used to describe patterns of outpatient healthcare use (e.g., primary, reproductive, mental health care) and therapeutic management (e.g., medication prescriptions, psychotherapy) by age. Period prevalence and median number of visits are reported. Additional analysis explored utilization patterns by mental health disorder.
The prevalence of outpatient mental health care and primary care decreased with age, with a larger drop in primary care utilization. While 74.0-78.4% of those aged 12-17 years used both outpatient mental health care and primary care, 53.1-59.7% of those aged 18-27 years did. Most 18-19-year-olds had a visit with an internal medicine or family medicine specialist, a minority had a pediatrician visit. The prevalence of medication management increased with age, while the prevalence of psychotherapy decreased.
Taken together, this descriptive study illustrates age-related differences in outpatient healthcare utilization among those with mental health disorders. Additionally, those with the most severe mental health disorders seem to be least connected to outpatient care. This knowledge can inform efforts to improve utilization of healthcare across the transition to adulthood.
本研究旨在描述精神障碍青少年和青年患者的门诊医疗服务利用模式随年龄的变化。
我们使用 IBM MarketScan 商业数据库，于 2018 年确定了 359413 名连续参加私人健康保险的有精神障碍的青少年和青年（12-27 岁）。采用探索性分析描述了门诊医疗服务（如初级保健、生殖保健、精神保健）和治疗管理（如药物处方、心理治疗）随年龄的变化模式。报告了期间患病率和就诊中位数。进一步分析了精神障碍的利用模式。
精神卫生保健和初级保健的门诊就诊率随年龄增长而降低，初级保健利用率下降幅度更大。虽然 12-17 岁患者中 74.0%-78.4%同时使用门诊精神卫生保健和初级保健，但 18-27 岁患者中这一比例为 53.1%-59.7%。大多数 18-19 岁患者有内科或家庭医学专家就诊，但很少有儿科就诊。药物管理的患病率随年龄增长而增加，而心理治疗的患病率则下降。
综上所述，这项描述性研究说明了精神障碍患者门诊医疗服务利用模式随年龄的变化。此外，那些患有最严重精神障碍的患者似乎与门诊护理的联系最少。这些知识可以为改善成年过渡期间的医疗保健利用提供依据。
