Lee Yu Kyung, Trevisan Louis, S Fuehrlein Brian
Yale School of Medicine, Yale University School of Medicine, New Haven, USA.
Department of Psychiatry, Creighton University, Omaha, USA.
Community Ment Health J. 2023 Nov;59(8):1532-1536. doi: 10.1007/s10597-023-01140-y. Epub 2023 May 27.
Frequent utilizers of emergency services represent a clinically important cohort with potentially unmet health care needs despite demanding a high volume of costly services. However, not much is known about their longitudinal course. This study identified the top 20 utilizers of VA Connecticut's psychiatric emergency services and conducted a chart review of their longitudinal outcomes during an 11-year period between 2010 and 2020, including their visit diagnoses, medical and psychiatric comorbidities, and types and frequency of other medical services and supports received. At the index visit, 19 of the 20 patients had substance use disorder and 14 patients had at least one non-substance psychiatric diagnosis. Despite all patients receiving primary care and other services, such as residential treatments, outpatient therapy, and social work consults, 11 of the 12 patients remaining alive and residing in the state continued to utilize psychiatric emergency services in 2020, revealing a pattern of persistent use.
急诊服务的频繁使用者是一个具有临床重要性的群体，尽管他们需要大量昂贵的服务，但可能仍有未满足的医疗需求。然而，对于他们的病程知之甚少。本研究确定了康涅狄格州退伍军人事务部精神科急诊服务的前20位使用者，并对他们在2010年至2020年的11年期间的纵向结局进行了病历审查，包括他们的就诊诊断、医学和精神科合并症，以及接受的其他医疗服务和支持的类型和频率。在首次就诊时，20名患者中有19名患有物质使用障碍，14名患者至少有一种非物质性精神科诊断。尽管所有患者都接受了初级保健和其他服务，如住院治疗、门诊治疗和社会工作咨询，但在2020年，仍在世并居住在该州的12名患者中有11名继续使用精神科急诊服务，呈现出持续使用的模式。
