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本文引用的文献

1
Assessing Primary Care Contributions to Behavioral Health: A Cross-sectional Study Using Medical Expenditure Panel Survey.评估初级保健对行为健康的贡献:使用医疗支出面板调查的横断面研究。
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211023871. doi: 10.1177/21501327211023871.
2
Integrating Mental Health and Addiction Treatment Into General Medical Care: The Role of Policy.将心理健康与成瘾治疗纳入普通医疗保健:政策的作用。
Psychiatr Serv. 2020 Nov 1;71(11):1163-1169. doi: 10.1176/appi.ps.202000183. Epub 2020 Jun 3.
3
Primary Care Behavioral Health Training in Family Medicine Residencies: A Qualitative Study From a Large Health Care System.家庭医学住院医师的初级保健行为健康培训:来自大型医疗保健系统的定性研究。
Fam Med. 2020 Feb 6;52(3):174-181. doi: 10.22454/FamMed.2020.681872.
4
The Economic Case for the Prevention of Mental Illness.预防精神疾病的经济学论证。
Annu Rev Public Health. 2019 Apr 1;40:373-389. doi: 10.1146/annurev-publhealth-040617-013629. Epub 2019 Jan 2.
5
Training to reduce behavioral health disparities: How do we optimally prepare family medicine residents for practice in rural communities?减少行为健康差异的培训:我们如何以最佳方式让家庭医学住院医师为在农村社区执业做好准备?
Int J Psychiatry Med. 2017 May;52(3):298-312. doi: 10.1177/0091217417730294. Epub 2017 Sep 24.
6
Residents' Confidence Providing Primary Care With Behavioral Health Integration.住院医师在提供整合行为健康的初级保健方面的信心。
Fam Med. 2017 May;49(5):361-368.

家庭医学医师治疗行为健康问题的准备情况:一项混合方法研究。

Family Medicine Physician Readiness to Treat Behavioral Health Conditions: A Mixed Methods Study.

机构信息

University of South Carolina School of Medicine Greenville, Greenville, SC, USA.

Clemson University College of Behavioral, Social, and Health Sciences, Clemson, SC, USA.

出版信息

J Prim Care Community Health. 2024 Jan-Dec;15:21501319241275053. doi: 10.1177/21501319241275053.

DOI:10.1177/21501319241275053
PMID:39212110
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11366095/
Abstract

INTRODUCTION

Behavioral and mental health conditions present significant challenges in the United States where access to care is limited. Family medicine physicians play a crucial role in addressing these challenges, often serving as frontline clinicians for behavioral and mental health conditions.

METHODS

This study examined the current behavioral and mental health system in a predominantly rural 10-county region in the Southeastern United States through gap analysis in addition to a survey of preparedness and barriers among family medicine physicians in the region.

RESULTS

Gap analysis results indicated that (1) stigma and lack of accessible education about behavioral and mental health, (2) fragmented resources, (3) inaccessible care, and (4) workforce shortage and burnout were primary drivers of poor outcomes in the region. Survey results indicated that physicians feel prepared to treat anxiety and depression but feel less prepared to manage bipolar disorder, schizophrenia, and substance use disorders. Respondents disagreed that there are adequate local resources and referral options for patients with behavioral and mental health conditions. Lack of timely access, distance, cost/insurance status, were all cited by respondents as barriers to appropriate care.

CONCLUSION AND RECOMMENDATIONS

Findings underscore the importance of supporting family medicine physicians to enhance behavioral and mental healthcare outcomes. Behavioral health integration in primary care settings is a promising strategy to improve care accessibility and clinician preparedness. Bridging gaps in health care outcomes requires collaborative efforts, enhanced training, and policy advocacy within the family medicine community to ensure comprehensive and equitable behavioral and mental healthcare delivery.

摘要

简介

在美国,行为和心理健康状况带来了巨大的挑战,而获得医疗服务的机会有限。家庭医学医师在应对这些挑战方面发挥着至关重要的作用,他们通常是行为和心理健康问题的一线临床医生。

方法

本研究通过差距分析以及对该地区家庭医学医师的准备情况和障碍进行调查,考察了美国东南部一个以农村为主的 10 个县地区当前的行为和心理健康系统。

结果

差距分析结果表明,(1)对行为和心理健康的污名化和缺乏可及的教育,(2)资源分散,(3)难以获得医疗服务,以及(4)劳动力短缺和倦怠,是该地区不良结果的主要驱动因素。调查结果表明,医生们认为自己有能力治疗焦虑和抑郁,但在管理双相情感障碍、精神分裂症和物质使用障碍方面的准备不足。受访者不同意该地区有足够的针对行为和心理健康问题患者的当地资源和转介选择。缺乏及时的可及性、距离、费用/保险状况等,都是受访者认为的适当护理障碍。

结论和建议

研究结果强调了支持家庭医学医师以改善行为和心理健康医疗结果的重要性。在初级保健环境中进行行为健康整合是改善护理可及性和临床医生准备度的有前途的策略。要弥合医疗保健结果方面的差距,需要家庭医学界内部进行协作努力、加强培训和政策倡导,以确保提供全面和公平的行为和心理健康医疗服务。