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在初级保健中治疗不同精神和物质使用障碍患者亚组的医疗保健专业人员的患者共享网络特征存在差异。

Variation in patient-sharing network characteristics of health care professionals treating different mental and substance use disorder patient sub-groups in primary care.

机构信息

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.

Finnish Institute for Health and Welfare, Helsinki, Finland.

出版信息

Int J Soc Psychiatry. 2024 Dec;70(8):1442-1452. doi: 10.1177/00207640241270827. Epub 2024 Aug 30.

Abstract

BACKGROUND

Providing efficient and targeted services for patients with mental health problems requires efficient collaboration and coordination within healthcare providers, but measuring collaboration using traditional methods is challenging.

AIMS

To explore the patient-sharing networks of professionals taking care of different groups of patients with mental or substance use disorders.

METHOD

We used data that covered adult patients' visits to the primary care service providers of seven municipalities in Finland during year 2021. Data included 8,217 patients (147,430 visits) with mental or substance use disorders who were treated by 1,566 health care professionals. We calculated descriptive network metrics to examine the connectivity of professionals in three different patient groups (patients with substance use disorders, psychotic disorders, and depressive disorders) and compared these characteristics to a network based on all patients. We also analyzed whether patient sharing was associated with the health care professionals' attributes (occupational group, municipality) using Exponential Random Graph Models (ERGM).

RESULTS

Diagnosis-specific networks were denser and more connected compared to the all-patients network. Nurses were the most central occupation in all the diagnosis-specific networks and especially in the substance use disorder patients network. When examining all patients, two professionals were more likely to share patients when they belonged to the same occupational group. However, in the network with depressive disorder patients we found the opposite: professionals were more likely to share patients if they were of different occupational groups.

CONCLUSIONS

Patient-sharing networks within patients with a specific mental or substance use disorders are denser and more connected than networks based on all patients with mental or substance use disorders. In the substance use disorder patients network particularly, nurses were the most central occupation. Multi-professional connections were more likely in depressive disorder networks than in the all-patients network.

摘要

背景

为有心理健康问题的患者提供高效、有针对性的服务,需要医疗服务提供者之间进行高效的协作和协调,但使用传统方法衡量协作关系具有挑战性。

目的

探索照顾精神或物质使用障碍患者不同群体的专业人员之间的患者共享网络。

方法

我们使用了涵盖 2021 年芬兰七个城市的初级保健服务提供者为成年患者提供的就诊数据。数据包括 8217 名(147430 次就诊)患有精神或物质使用障碍的患者,由 1566 名医疗保健专业人员进行治疗。我们计算了描述性网络指标,以检查三种不同患者群体(物质使用障碍患者、精神病患者和抑郁障碍患者)中专业人员的连接性,并将这些特征与基于所有患者的网络进行比较。我们还使用指数随机图模型(ERGM)分析了患者共享是否与医疗保健专业人员的属性(职业群体、城市)相关。

结果

与所有患者网络相比,特定诊断的网络更密集且连接更紧密。护士是所有特定诊断网络中最具中心地位的职业,尤其是在物质使用障碍患者网络中。在检查所有患者时,如果两个专业人员属于同一职业群体,他们更有可能共享患者。然而,在患有抑郁障碍的患者网络中,我们发现了相反的情况:如果专业人员属于不同的职业群体,他们更有可能共享患者。

结论

特定精神或物质使用障碍患者的患者共享网络比基于所有精神或物质使用障碍患者的网络更密集且连接更紧密。在物质使用障碍患者网络中,护士是最具中心地位的职业。与所有患者网络相比,抑郁障碍网络中多专业人员的联系更有可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6aa/11528958/c704dfe22a3d/10.1177_00207640241270827-fig1.jpg

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