在初级保健中治疗有自杀意念的个体：与协作式护理模式中的随访相关的患者特征。
Treating individuals with suicidal ideation in primary care: Patient-level characteristics associated with follow-up in the Collaborative Care Model.
机构信息
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
出版信息
Suicide Life Threat Behav. 2024 Feb;54(1):15-23. doi: 10.1111/sltb.13012. Epub 2023 Nov 2.
INTRODUCTION
The Collaborative Care Model (CoCM) is an evidence-based approach which embeds behavioral health providers (BHPs) into primary care. Whether patients with suicidal ideation (SI) are willing to engage in CoCM is unclear.
METHODS
Using Patient Health Questionnaire-9 (PHQ-9) administrative data from primary care practices within an urban academic health system, we identified patients with and without SI who were referred to a CoCM BHP. We compared engagement, defined as attendance at ≥1 CoCM visit, across groups.
RESULTS
Between 2018 and 2022, 7391 primary care patients were referred to a CoCM BHP. Eight hundred and ninety-two of these patients reported SI on the PHQ-9 (754 on "several days" during the previous 2 weeks and 138 on "more than half or most days"). Across groups, most patients engaged in CoCM. Patients reporting SI on several days engaged at a lower rate (61.4%) than those reporting SI on more than half or most days (65.9%). Both SI groups engaged at a lower rate than the 6499 patients who did not report SI (67.5%).
CONCLUSION
Most patients referred to a CoCM BHP engaged in ≥1 visit. Rates were lower for patients with SI, with the lowest rate among those reporting SI on several days.
介绍
合作式护理模式（CoCM）是一种循证方法，将行为健康提供者（BHPs）嵌入到初级保健中。是否有自杀意念（SI）的患者愿意接受 CoCM 尚不清楚。
方法
我们使用城市学术医疗系统内初级保健实践中的患者健康问卷-9（PHQ-9）行政数据，确定了被转诊给 CoCM BHP 的有和没有 SI 的患者。我们比较了各组之间的参与情况，定义为至少参加 1 次 CoCM 就诊。
结果
在 2018 年至 2022 年期间，7391 名初级保健患者被转诊给 CoCM BHP。其中 892 名患者在 PHQ-9 上报告有 SI（754 名在过去 2 周内有“几天”，138 名在“超过一半或大部分时间”）。在各组中，大多数患者参与了 CoCM。报告有几天 SI 的患者参与率（61.4%）低于报告有超过一半或大部分时间 SI 的患者（65.9%）。这两个 SI 组的参与率都低于未报告 SI 的 6499 名患者（67.5%）。
结论
大多数被转诊给 CoCM BHP 的患者至少参加了 1 次就诊。有 SI 的患者的参与率较低，其中报告有几天 SI 的患者的参与率最低。
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