Niedzwiedz Claire L, Aragón María José, Breedvelt Josefien J F, Smith Daniel J, Prady Stephanie L, Jacobs Rowena
School of Health and Wellbeing, University of Glasgow, UK.
Centre for Health Economics, University of York, UK.
BJPsych Open. 2023 Nov 7;9(6):e211. doi: 10.1192/bjo.2023.602.
People with mental disorders have worse physical health compared with the general population, which could be attributable to receiving poorer quality healthcare.
To examine the relationship between severe and common mental disorders and risk of emergency hospital admissions for ambulatory care sensitive conditions (ACSCs), and factors associated with increased risk.
Baseline data for England ( = 445 814) were taken from UK Biobank, which recruited participants aged 37-73 years during 2006-2010, and linked to hospital admission records up to 31 December 2019. Participants were grouped into those with a history of either schizophrenia, bipolar disorder, depression or anxiety, or no mental disorder. Survival analysis was used to assess the risk of hospital admission for ACSCs among those with mental disorders compared with those without, adjusting for factors in different domains (sociodemographic, socioeconomic, health and biomarkers, health-related behaviours, social isolation and psychological).
People with schizophrenia had the highest (unadjusted) risk of hospital admission for ACSCs compared with those with no mental disorder (hazard ratio 4.40, 95% CI 4.04-4.80). People with bipolar disorder (hazard ratio 2.48, 95% CI 2.28-2.69) and depression or anxiety (hazard ratio 1.76, 95% CI 1.73-1.80) also had higher risk. Associations were more conservative when including all admissions, as opposed to first admissions only. The observed associations persisted after adjusting for a range of factors.
People with severe mental disorders have the highest risk of preventable hospital admissions. Ensuring people with mental disorders receive adequate ambulatory care is essential to reduce the large health inequalities they experience.
与普通人群相比，精神障碍患者的身体健康状况更差，这可能归因于他们获得的医疗保健质量较低。
研究严重和常见精神障碍与非卧床护理敏感疾病（ACSCs）紧急住院风险之间的关系，以及与风险增加相关的因素。
英格兰的基线数据（n = 445814）取自英国生物银行，该银行在2006年至2010年期间招募了37至73岁的参与者，并与截至2019年12月31日的住院记录相关联。参与者被分为有精神分裂症、双相情感障碍、抑郁症或焦虑症病史的人群，以及无精神障碍的人群。生存分析用于评估有精神障碍者与无精神障碍者相比因ACSCs住院的风险，并对不同领域（社会人口统计学、社会经济、健康和生物标志物、健康相关行为、社会隔离和心理）的因素进行调整。
与无精神障碍者相比，精神分裂症患者因ACSCs住院的（未调整）风险最高（风险比4.40，95%置信区间4.04 - 4.80）。双相情感障碍患者（风险比2.48，95%置信区间2.28 - 2.69）以及抑郁症或焦虑症患者（风险比1.76，95%置信区间1.73 - 1.80）的风险也较高。当纳入所有住院病例而非仅首次住院病例时，关联更为保守。在对一系列因素进行调整后，观察到的关联仍然存在。
严重精神障碍患者可预防住院的风险最高。确保精神障碍患者获得充分的非卧床护理对于减少他们所经历的巨大健康不平等至关重要。
