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患者在急诊部门苦苦挣扎:2016-17 年至 2020-21 年期间澳大利亚心理健康相关急诊部门就诊情况的描述性分析。

Patients languishing in emergency departments: A descriptive analysis of mental health-related emergency department presentations in Australia between 2016-17 and 2020-21.

机构信息

Academic Unit of Psychiatry and Addiction Medicine, School of Medicine and Psychology, The Australian National University, Canberra Hospital, Canberra, ACT, Australia.

Department of Psychiatry, The Canberra Hospital, Garran, ACT, Australia; and.

出版信息

Australas Psychiatry. 2023 Oct;31(5):646-651. doi: 10.1177/10398562231195438. Epub 2023 Aug 15.

Abstract

OBJECTIVE

In the context of concerns regarding hospital access block, this paper provides a descriptive longitudinal analysis of mental health-related ED episodes in Australian public hospitals between 2016-17 and 2020-21.

METHOD

We descriptively analysed Australian Institute of Health and Welfare data for mental health-related ED presentations, outcomes and 5-year trends for Australian public hospitals.

RESULTS

There were more than 300,000 Australian mental health-related ED presentations in 2020-21. Presentations increased by an average annual rate of 2.8% between 2016-17 and 2020-21, commonly involving first responder (police, paramedic) attendance. From 2016-17 to 2020-21, the average annual rate of mental health-related ED presentations receiving a triage category of resuscitation increased by 13.7%, emergency by 9.4% and urgent by 4.7%. 90% of MH-related ED presentations were completed within 14 h, which was longer than the 90 percentile for all ED presentations (up to 8 h).

CONCLUSIONS

Current mental health policies have not stemmed the rising tide of ED presentations. Mental health-related ED presentations are increasing in number and severity, likely due to health systemic and societal factors. Psychiatry patients stay longer in EDs than other patients. Healthcare reforms should be targeted to provide the best outcome based on principles of equity of access.

摘要

目的

在关注医院通道阻塞的背景下,本文对澳大利亚公立医院 2016-17 年至 2020-21 年期间与心理健康相关的急症室就诊情况进行了描述性的纵向分析。

方法

我们对澳大利亚卫生福利研究所关于澳大利亚公立医院心理健康相关急症室就诊情况、结果和 5 年趋势的数据进行了描述性分析。

结果

2020-21 年有超过 30 万澳大利亚人因心理健康问题到急症室就诊。2016-17 年至 2020-21 年期间,就诊人数以平均每年 2.8%的速度增长,通常涉及到第一响应者(警察、护理人员)的参与。2016-17 年至 2020-21 年,接受复苏分类的心理健康相关急症室就诊的平均年增长率增加了 13.7%,紧急就诊增加了 9.4%,紧急就诊增加了 4.7%。90%的 MH 相关急症室就诊在 14 小时内完成,这比所有急症室就诊(最长 8 小时)的 90 分位数都要长。

结论

当前的心理健康政策并没有遏制急症室就诊人数的上升趋势。与心理健康相关的急症室就诊数量和严重程度都在增加,这可能是由于医疗系统和社会因素造成的。精神科患者在急症室停留的时间比其他患者长。医疗改革应针对提供基于公平准入原则的最佳结果。

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