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[基层医疗向心理健康服务转诊的研究:转诊原因与专科诊断之间存在何种巧合]

[Study of referrals from primary care to mental health: What coincidence does exist between the reasons for the referral and the diagnosis of the specialist].

作者信息

García-Testal A, Sancho Blasco F, Julve Pardo R, Puche Pinazo E, Rabanaque Mallén G

机构信息

Centro de Salud Puerto de Sagunto.

出版信息

Aten Primaria. 1998 Sep 15;22(4):233-8.

PMID:9803576
Abstract

OBJECTIVE

To evaluate the diagnoses of Primary Care (PC) by their confirmation in psychiatry.

DESIGN

Observational, descriptive and retrospective study.

LOCATION

Unit of Mental Health (MH) of Sagunto and Center of Health Puerto de Sagunto.

POPULATION

The formless for the derivation of PC to MH between June 1996 and May 1997, 147 patients.

RESULTS

The incidence was higher in females. More frequent pathology: neurotic dysfunctions and secondary to stress, continued by affective dysfunctions. 21% (IC 95%: 14.4-29.6) they were derived without diagnosis. The psychiatry confirmed 70% (IC 95%: 59.6-78.8) of the diagnoses of primary care. 14% (IC 95%: 8.3-21.4) they were considered without psychiatric pathology for MH. 25% (IC 95%: 17.2-33.2) of patients were discharged in first visit to MH. 17% (IC 95%: 11.3-24.1) of the first requested visits didn't go to the consultation.

CONCLUSIONS

The coincidence in the psychiatric diagnoses of the doctors of PC of the Puerto de Sagunto with the SM is bigger than the coincidence in previous studies of other areas. The most frequent confusion is among neurotic dysfunctions and secondary to stress with affective dysfunctions. The suspected diagnosis should be reflected in more occasions. It is high the number of patients that didn't go to the appointment with SM. The communication between services could be improve.

摘要

目的

通过在精神病学中的确诊情况评估初级保健(PC)的诊断。

设计

观察性、描述性和回顾性研究。

地点

萨贡托心理健康科(MH)和萨贡托港健康中心。

研究对象

1996年6月至1997年5月间从PC转诊至MH的147例无特定形式患者。

结果

女性发病率更高。最常见的病症:神经功能障碍及应激所致继发性病症,其次是情感功能障碍。21%(95%置信区间:14.4 - 29.6)的患者转诊时未确诊。精神病学确诊了初级保健诊断的70%(95%置信区间:59.6 - 78.8)。14%(95%置信区间:8.3 - 21.4)的患者被认为无MH相关精神病症。25%(95%置信区间:17.2 - 33.2)的患者在首次就诊于MH时出院。17%(95%置信区间:11.3 - 24.1)的首次预约就诊患者未前往咨询。

结论

萨贡托港PC医生的精神病学诊断与精神疾病诊断标准(SM)的相符度高于其他地区以往研究中的相符度。最常见的混淆存在于神经功能障碍及应激所致继发性病症与情感功能障碍之间。疑似诊断应在更多情况下予以体现。未赴SM预约就诊的患者数量较多。各服务部门之间的沟通有待改善。

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