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在新冠疫情期间,与大型学术医疗系统中门诊精神科治疗中断相关的因素

Factors Associated with Leaving Ambulatory Psychiatric Treatment in a Large, Academic Health System During the COVID-19 Pandemic.

作者信息

Sowa Nathaniel A, Zeng Xiaoming

机构信息

Department of Psychiatry, UNC School of Medicine, Chapel Hill, NC, USA.

出版信息

Psychiatr Q. 2025 Mar 19. doi: 10.1007/s11126-025-10129-7.

Abstract

Detailed evaluation of changes in patient retention in psychiatric care as a result of the onset of the COVID-19 pandemic have not been studied. Here, we present a retrospective analysis of aggregate data from a large academic health system (n = 16,701 patients) to examine if there were differences in patients leaving psychiatric care from the pre-COVID-19 period to the first 12 months of the COVID-19 pandemic. Demographic, clinical, and behavioral factors were studied using logistic regressions to determine significant associations in leaving psychiatric care during COVID-19 and in the 12 months immediately prior to the pandemic. Factors identified with a higher odds of leaving psychiatric care during COVID-19 that were not associated with leaving care prior to COVID-19 included demographic (male sex, uninsured (self-pay) status), behavioral (inactive patient health portal), and diagnostic (anxiety and trauma stressor disorders, pervasive and specific developmental disorders, and disorders of childhood) factors. These results highlight that the reasons patients left care during the period immediately after the COVID-19 pandemic may have been multifactorial in nature, although certain patterns seem to have appeared. Further study is needed to elucidate why these specific factors may have driven patients to leave psychiatric treatment during the COVID-19 pandemic.

摘要

尚未对因新冠疫情爆发导致的精神科护理患者留存率变化进行详细评估。在此,我们对来自一个大型学术健康系统(n = 16701名患者)的汇总数据进行回顾性分析,以研究在新冠疫情前至疫情的前12个月期间,离开精神科护理的患者是否存在差异。使用逻辑回归研究人口统计学、临床和行为因素,以确定在新冠疫情期间及疫情前12个月离开精神科护理的显著关联因素。在新冠疫情期间离开精神科护理几率较高且与疫情前离开护理无关的因素包括人口统计学因素(男性、未参保(自费)状态)、行为因素(患者健康门户不活跃)和诊断因素(焦虑和创伤应激障碍、广泛性和特定发育障碍以及儿童期障碍)。这些结果表明,新冠疫情后立即出现的患者离开护理的原因可能具有多因素性质,尽管某些模式似乎已经出现。需要进一步研究以阐明为何这些特定因素可能导致患者在新冠疫情期间离开精神科治疗。

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