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首页> 外文期刊>Journal of the American Academy of Child and Adolescent Psychiatry >Outpatient care of young people after emergency treatment of deliberate self-harm
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Outpatient care of young people after emergency treatment of deliberate self-harm

机译：紧急治疗后故意故意伤害青少年的门诊服务

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Objective: Little is known about the mental health care received by young people after an episode of deliberate self-harm. This study examined predictors of emergency department (ED) discharge, mental health assessments in the ED, and follow-up outpatient mental health care for Medicaid-covered youth with deliberate self-harm. Method: A retrospective longitudinal cohort analysis was conducted of national 2006 Medicaid claims data supplemented with the Area Resource File and a Substance Abuse and Mental Health Services Administration Medicaid policy survey of state policy characteristics focusing on ED treatment episodes by youth 10 to 19 years old for deliberate self-harm (n = 3,241). Rates and adjusted risk ratios (ARR) of discharge to the community, mental health assessments in the ED, and outpatient visits during the 30 days after the ED visit were assessed. Results: Most patients (72.9%) were discharged to the community. Discharge was inversely related to recent psychiatric hospitalization (ARR 0.75, 99% confidence interval [CI] 0.630.90). Thirty-nine percent of discharged patients received a mental health assessment in the ED and a roughly similar percentage (43.0%) received follow-up outpatient mental health care. Follow-up mental health care was directly related to recent outpatient (ARR 2.58, 99% CI 2.272.94) and inpatient (ARR 1.33, 99% CI 1.141.56) mental health care and inversely related to Hispanic ethnicity (ARR 0.78, 99% CI 0.640.95) and residence in a county with medium-to-high poverty rates (ARR 0.84, 99% CI 0.730.97). Conclusions: A substantial proportion of young Medicaid beneficiaries who present to EDs with deliberate self-harm are discharged to the community and do not receive emergency mental health assessments or follow-up outpatient mental health care.
机译：目的：人们对故意的自残事件后青少年获得的心理保健知之甚少。这项研究检查了急诊科（ED）出院，ED中的心理健康评估以及故意自残的医疗补助覆盖青年的门诊心理健康护理的预测因素。方法：对2006年国家医疗补助申请数据进行了回顾性纵向队列分析，补充了“地区资源档案”和物质滥用和精神卫生服务管理局的医疗补助政策调查，重点研究了10至19岁青少年的急诊治疗事件。故意的自我伤害（n = 3,241）。评估出院率，调整后的出院风险比（ARR），急诊室的精神健康评估以及急诊室就诊后30天内的门诊就诊率。结果：大多数患者（72.9％）已出院。出院与最近的精神病院住院成反比（ARR 0.75，99％置信区间[CI] 0.630.90）。 39％的出院患者在急诊室接受了心理健康评估，大致相似的百分比（43.0％）接受了后续门诊心理健康护理。后续心理健康护理与近期门诊患者（ARR 2.58，99％CI 2.272.94）和住院患者（ARR 1.33，99％CI 1.141.56）直接相关，与西班牙裔患者（ARR 0.78，99）呈负相关％CI（0.640.95），并居住在中等偏高贫困率的县（ARR 0.84，99％CI 0.730.97）。结论：故意向自我ED求诊的急诊部的年轻医疗补助受益者中有很大一部分已出院，没有接受紧急心理健康评估或后续门诊心理健康护理。

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