Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA.
Department of Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA.
J Eval Clin Pract. 2024 Mar;30(2):243-250. doi: 10.1111/jep.13939. Epub 2023 Nov 7.
Integrating primary care services in mental healthcare facilities is an uncommon model of care in the United States that could bring several benefits (e.g., improved access to physical healthcare) for vulnerable populations experiencing mental health conditions, especially those living in underserved regions like rural Arizona.
This formative assessment aimed to understand the sociodemographic and clinical characteristics of clients accessing integrated primary care (IPC) services implemented in 2021 at a community mental healthcare facility in rural Arizona and to explore the proportion of missed appointments. Additionally, we analysed the association between client characteristics and IPC missed appointments.
The authors collaborated with a community mental health facility in rural Arizona, which provided deidentified data from 280 clients who accessed IPC services from June 2021 to February 2022.
Most clients were White and of vulnerable socioeconomic status, with a substantial proportion of Native Americans (23.58%). The majority of clients (55.75%) had a mental health disorder (MHD), 23.74% had a substance use disorder (SUD), and 15.10% had comorbid MHD and SUD. Linear regression revealed that experiencing comorbid MHD and SUD was significantly associated with missed appointments. Compared with White clients, Native Americans missed fewer appointments.
Future studies conducted from a culturally-centred perspective are crucial to guide strategies to reduce missed appointments in rural IPC services.
将初级保健服务整合到精神保健设施中是美国一种不常见的护理模式，可为有心理健康问题的弱势群体（特别是居住在亚利桑那州农村等服务不足地区的人）带来多项益处（例如，改善获得物理保健的机会）。
这项初步评估旨在了解 2021 年在亚利桑那州农村社区心理健康保健机构实施的综合初级保健（IPC）服务所服务的客户的社会人口学和临床特征，并探讨错过预约的比例。此外，我们分析了客户特征与 IPC 错过预约之间的关联。
作者与亚利桑那州农村的一家社区心理健康机构合作，该机构提供了 280 名客户的数据，这些客户在 2021 年 6 月至 2022 年 2 月期间使用了 IPC 服务。
大多数客户是白人且社会经济地位脆弱，其中相当一部分是美洲原住民（23.58%）。大多数客户（55.75%）患有精神健康障碍（MHD），23.74%患有物质使用障碍（SUD），15.10%患有 MHD 和 SUD 共病。线性回归显示，同时患有 MHD 和 SUD 与错过预约显著相关。与白人客户相比，美洲原住民错过的预约较少。
未来需要从以文化为中心的角度开展研究，以指导策略来减少农村 IPC 服务中的预约流失。
