School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
Sunshine Coast Health Network, Maroochydore, Queensland, Australia.
BMJ Open. 2023 Jul 7;13(7):e072404. doi: 10.1136/bmjopen-2023-072404.
Mental well-being is a global public health priority with increasing mental health conditions having substantial burden on individuals, health systems and society. 'Stepped care', where services are provided at an intensity to meet the changing needs of the consumer, is the chosen approach to mental health service delivery in primary healthcare in Australia for its efficiencies and patient outcomes; yet limited evidence exists on how the programme is being rolled out and its impact in practice. This protocol outlines a data linkage project to characterise and quantify healthcare service utilisation and impacts among a cohort of consumers of a national mental health stepped care programme in one region of Australia.
Data linkage will be used to establish a retrospective cohort of consumers of mental health stepped care services between 1 July 2020 and 31 December 2021 in one primary healthcare region in Australia (n=approx. 12 710). These data will be linked with records from other healthcare service data sets (eg, hospitalisations, emergency department presentations, community-based state government-delivered mental healthcare, hospital costs). Four areas for analysis will include: (1) characterising the nature of mental health stepped care service use; (2) describing the cohort's sociodemographic and health characteristics; (3) quantifying broader service utilisation and associated economic costs; and (4) assessing the impact of mental health stepped care service utilisation on health and service outcomes.
Approval from the Darling Downs Health Human Research Ethics Committee (HREA/2020/QTDD/65518) has been granted. All data will be non-identifiable, and research findings will be disseminated through peer-reviewed journals, conference presentations and industry meetings.
心理健康是全球公共卫生的重点关注领域，不断增加的心理健康问题给个人、卫生系统和社会带来了巨大负担。“阶梯式护理”是澳大利亚初级医疗保健中心提供精神卫生服务的首选方法，这种方法根据消费者需求的变化提供服务强度，以提高服务效率和改善患者预后；然而，关于该项目的实施方式及其实际效果的证据有限。本方案概述了一个数据链接项目，旨在描述和量化澳大利亚一个地区全国性精神卫生阶梯式护理项目的消费者的医疗服务利用情况及其影响。
将使用数据链接建立一个澳大利亚一个初级医疗保健地区（约 12710 人）在 2020 年 7 月 1 日至 2021 年 12 月 31 日期间接受精神卫生阶梯式护理服务的消费者回顾性队列。这些数据将与其他医疗保健数据集（如住院、急诊就诊、社区提供的州政府精神卫生保健、医院费用）的记录进行链接。分析将包括四个方面：（1）描述阶梯式精神卫生护理服务利用的性质；（2）描述队列的社会人口学和健康特征；（3）量化更广泛的服务利用和相关经济成本；（4）评估精神卫生阶梯式护理服务利用对健康和服务结果的影响。
已获得达令唐斯卫生人体研究伦理委员会（HREA/2020/QTDD/65518）的批准。所有数据将是非可识别的，研究结果将通过同行评议的期刊、会议演讲和行业会议进行传播。
