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电子心理健康服务与南伦敦医保记录的关联:设计、流程和描述性结果。

Linking electronic mental healthcare and benefits records in South London: design, procedure and descriptive outcomes.

机构信息

Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK

King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

出版信息

BMJ Open. 2023 Feb 15;13(2):e067136. doi: 10.1136/bmjopen-2022-067136.

Abstract

OBJECTIVES

To describe the process and outcomes of a data linkage between electronic secondary mental healthcare records from the South London and Maudsley (SLaM) NHS Foundation Trust with benefits records from the Department for Work and Pensions (DWP). We also describe the mental health and benefit profile of patients who were successfully linked.

DESIGN

A deterministic linkage of routine records from health and welfare government service providers within a secure environment.

SETTING AND PARTICIPANTS

Adults aged≥18 years who were referred to or accessed treatment at SLaM services between January 2007 and June 2019, including those who were treated as part of Improving Access to Psychological Therapies (IAPT) services between January 2008 and June 2019 (n=448 404). Benefits data from the DWP from January 2005 to June 2020.

OUTCOME MEASURES

The linkage rate and associated sociodemographic, diagnostic and treatment factors. Recorded primary psychiatric diagnosis based on International Classification of Diseases (ICD)-10 codes and type of benefit receipt.

RESULTS

A linkage rate of 92.3% was achieved. Women, younger patients and those from ethnic minority groups were less likely to be successfully linked. Patients who had subsequently died, had a recorded primary psychiatric diagnosis, had also engaged with IAPT and had a higher number of historical postcodes available were more likely to be linked. Overall, 83% of patients received benefits at some point between 2005 and 2020. Benefit receipt across the psychiatric diagnosis spectrum was high, over 80% across most ICD-10 codes.

CONCLUSIONS

This data linkage is the first of its kind in the UK demonstrating the use of routinely collected mental health and benefits data. Benefit receipt was high among patients accessing SLaM services and varied by psychiatric diagnosis. Future areas of research are discussed, including exploring the effectiveness of interventions for helping people into work and the impact of benefit reforms.

摘要

目的

描述南伦敦和莫兹利 (SLaM) NHS 基金会信托基金的电子二级精神卫生保健记录与英国工作和养老金部 (DWP) 的福利记录之间的数据链接过程和结果。我们还描述了成功链接的患者的精神健康和福利状况。

设计

在安全环境中对来自卫生和福利政府服务提供者的常规记录进行确定性链接。

设置和参与者

2007 年 1 月至 2019 年 6 月期间在 SLaM 服务机构转诊或接受治疗的年龄≥18 岁的成年人,包括在 2008 年 1 月至 2019 年 6 月期间作为改善心理治疗机会 (IAPT) 服务一部分接受治疗的患者(n=448404)。来自 DWP 的福利数据来自 2005 年 1 月至 2020 年 6 月。

结果测量

链接率及相关社会人口统计学、诊断和治疗因素。根据国际疾病分类(ICD-10)代码和受益类型记录的主要精神科诊断。

结果

实现了 92.3%的链接率。女性、年轻患者和少数族裔群体的患者不太可能成功链接。随后死亡、有记录的主要精神科诊断、也参与了 IAPT 且有更多历史邮政编码可用的患者更有可能被链接。总体而言,83%的患者在 2005 年至 2020 年期间的某个时间领取了福利。在整个精神科诊断范围内,福利领取率很高,超过 80%的 ICD-10 代码。

结论

这是英国首例此类数据链接,展示了常规收集的精神卫生和福利数据的使用。在 SLaM 服务机构就诊的患者中,福利领取率很高,大多数 ICD-10 代码的福利领取率都超过 80%。未来的研究领域包括探索帮助人们就业的干预措施的有效性和福利改革的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1485/9950921/3fad37fd3361/bmjopen-2022-067136f01.jpg

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