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首页> 外文期刊>General hospital psychiatry >Continuation of care following an initial primary care visit with a mental health diagnosis: Differences by receipt of VHA Primary Care-Mental Health Integration services
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Continuation of care following an initial primary care visit with a mental health diagnosis: Differences by receipt of VHA Primary Care-Mental Health Integration services

机译：在进行初次就诊并进行精神健康诊断后继续就医：接受VHA初次保健-精神健康整合服务的差异

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Objective: For patients with an initial primary care (PC) encounter in the Veterans Health Administration (VHA) that included a mental health diagnosis, we evaluate whether same-day receipt of Primary Care-Mental Health Integration (PC-MHI) services is associated with the likelihood of receiving a subsequent mental-health-related encounter in the following 90 days. Method: Using VHA administrative data, we identified 9046 patients who received VHA care for the first time in fiscal year 2009, received a PC encounter that included a mental health diagnosis on the first day of their VHA services and initiated care at a VHA facility that provided PC-MHI services. Using multivariable generalized estimating equations logistic regression, we examined whether receipt of same-day PC-MHI was associated with receipt of a subsequent encounter with a mental health diagnosis within 90 days. Analyses adjusted for Operation Enduring Freedom/Operation Iraqi Freedom Veteran status, demographic characteristics, service-connected disability, psychiatric and non-psychiatric diagnoses, and psychotropic medication initiation on the index day of service use. Results: Receipt of same-day PC-MHI services was positively associated with having a mental-health-related encounter in the following 90 days (adjusted odds ratio=2.05; 95% confidence interval=1.66-2.54). Conclusions: PC-MHI services may enhance mental health continuation of care among PC patients with mental health conditions who initiate VHA services.
机译：目的：对于在退伍军人健康管理局（VHA）中遇到的包括精神健康诊断在内的初次初级护理（PC）的患者，我们评估了是否与当天接受初级保健-精神健康整合（PC-MHI）服务相关在接下来的90天内可能会遇到与心理健康相关的后续遭遇。方法：使用VHA管理数据，我们确定了9046名患者在2009财年首次接受VHA护理，在其VHA服务的第一天就接受了包括心理健康诊断在内的PC遭遇，并在VHA设施中开始了护理提供了PC-MHI服务。使用多变量广义估计方程对数回归，我们检查了当日PC-MHI的接受是否与90天内精神病诊断的后续遭遇有关。在使用服务的当天，针对“持久自由行动/伊拉克自由退伍军人”状态，人口统计学特征，与服务有关的残疾，精神病学和非精神病学诊断以及精神药物治疗进行了调整。结果：在接下来的90天内，接受当天PC-MHI服务与与心理健康相关的经历呈正相关（调整后的优势比= 2.05; 95％的置信区间= 1.66-2.54）。结论：PC-MHI服务可增强患有精神卫生状况且开始VHA服务的PC患者的心理健康持续性。

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