封锁还是封锁?COVID-19大流行期间精神科急诊服务的使用趋势。

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES Journal of Health Services Research & Policy Pub Date : 2023-04-01 Epub Date: 2022-12-06 DOI:10.1177/13558196221135119
Alison Duncan, Carolina-Nicole Herrera, Margaret Okobi, Shurobhi Nandi, Rachel Oblath
{"title":"封锁还是封锁?COVID-19大流行期间精神科急诊服务的使用趋势。","authors":"Alison Duncan, Carolina-Nicole Herrera, Margaret Okobi, Shurobhi Nandi, Rachel Oblath","doi":"10.1177/13558196221135119","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To estimate changes in Boston Emergency Services Team (BEST) psychiatric emergency services (PES) encounter volume (total and by care team) and inpatient disposition during the first 8 months of the COVID-19 pandemic.</p><p><strong>Methods: </strong>Data on 30,657 PES encounters was extracted from the four-county, BEST reporting system. The study period consisted of the first 34 weeks of 2019 and 2020. This period corresponded to the first five stages of Massachusetts's COVID-19 public health restrictions: pre-lockdown, lockdown, Phase I, II and III reopenings. Descriptive and regression analyses were performed to estimate changes in encounter volume by care team and disposition.</p><p><strong>Results: </strong>Compared to the same period in 2019, covariate-adjusted, weekly PES encounters decreased by 39% (β = -0.40, 95% Confidence Interval (CI) = [-0.51, -0.28], <i>p</i> < 0.00) during the lockdown. PES volume remained significantly lower during Phase I reopening compared to the previous year but returned to 2019 levels during Phase II. The covariate-adjusted proportion of weekly encounters that led to inpatient admission significantly increased by 16% (CI = [0.11, 0.21], <i>p</i> < 0.00) for mobile crisis teams (MCTs) and significantly declined by 13% (CI = [-0.19, -0.07], <i>p</i> < 0.00) for BEST-designated emergency departments during the lockdown period compared to the prior year.</p><p><strong>Conclusions: </strong>The overall drop in PES utilization and the rise in inpatient admissions for MCT encounters suggests that during the early phases of the pandemic, patients delayed psychiatric care until they had a psychiatric crisis. Public health messaging about the lockdowns and absent equivalent messaging about the availability of telehealth services may have made patients more reluctant to seek psychiatric care.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732494/pdf/10.1177_13558196221135119.pdf","citationCount":"0","resultStr":"{\"title\":\"Locked down or locked out? Trends in psychiatric emergency services utilization during the COVID-19 pandemic.\",\"authors\":\"Alison Duncan, Carolina-Nicole Herrera, Margaret Okobi, Shurobhi Nandi, Rachel Oblath\",\"doi\":\"10.1177/13558196221135119\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To estimate changes in Boston Emergency Services Team (BEST) psychiatric emergency services (PES) encounter volume (total and by care team) and inpatient disposition during the first 8 months of the COVID-19 pandemic.</p><p><strong>Methods: </strong>Data on 30,657 PES encounters was extracted from the four-county, BEST reporting system. The study period consisted of the first 34 weeks of 2019 and 2020. This period corresponded to the first five stages of Massachusetts's COVID-19 public health restrictions: pre-lockdown, lockdown, Phase I, II and III reopenings. Descriptive and regression analyses were performed to estimate changes in encounter volume by care team and disposition.</p><p><strong>Results: </strong>Compared to the same period in 2019, covariate-adjusted, weekly PES encounters decreased by 39% (β = -0.40, 95% Confidence Interval (CI) = [-0.51, -0.28], <i>p</i> < 0.00) during the lockdown. PES volume remained significantly lower during Phase I reopening compared to the previous year but returned to 2019 levels during Phase II. The covariate-adjusted proportion of weekly encounters that led to inpatient admission significantly increased by 16% (CI = [0.11, 0.21], <i>p</i> < 0.00) for mobile crisis teams (MCTs) and significantly declined by 13% (CI = [-0.19, -0.07], <i>p</i> < 0.00) for BEST-designated emergency departments during the lockdown period compared to the prior year.</p><p><strong>Conclusions: </strong>The overall drop in PES utilization and the rise in inpatient admissions for MCT encounters suggests that during the early phases of the pandemic, patients delayed psychiatric care until they had a psychiatric crisis. Public health messaging about the lockdowns and absent equivalent messaging about the availability of telehealth services may have made patients more reluctant to seek psychiatric care.</p>\",\"PeriodicalId\":15953,\"journal\":{\"name\":\"Journal of Health Services Research & Policy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732494/pdf/10.1177_13558196221135119.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Health Services Research & Policy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/13558196221135119\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/12/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Health Services Research & Policy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/13558196221135119","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/12/6 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0

摘要

目的估算在 COVID-19 大流行的前 8 个月中,波士顿急救服务团队(BEST)精神科急救服务(PES)接诊量(总接诊量和护理团队接诊量)和住院病人处置情况的变化:从四个县的 BEST 报告系统中提取了 30,657 次精神科急诊服务的数据。研究期间包括 2019 年和 2020 年的前 34 周。这一时期与马萨诸塞州 COVID-19 公共卫生限制的前五个阶段相对应:封锁前、封锁、第一阶段、第二阶段和第三阶段重新开放。我们进行了描述性分析和回归分析,以估算按护理团队和处置方式划分的就诊量变化:与 2019 年同期相比,在封锁期间,经协变量调整后的每周 PES 就诊量减少了 39%(β = -0.40,95% 置信区间 (CI) = [-0.51, -0.28],p < 0.00)。与前一年相比,第一阶段重新开放期间的 PES 量仍然明显较低,但在第二阶段恢复到了 2019 年的水平。与前一年相比,在封锁期间,流动危机小组(MCT)每周导致住院的就诊比例经协变因素调整后大幅增加了 16% (CI = [0.11, 0.21],p < 0.00),而 BEST 指定急诊部门的就诊比例则大幅下降了 13% (CI = [-0.19, -0.07],p < 0.00):PES使用率的整体下降和MCT住院率的上升表明,在大流行病的早期阶段,患者推迟了精神科治疗,直到出现精神危机。有关封锁的公共卫生信息以及有关远程医疗服务可用性的同等信息的缺失可能使患者更不愿意寻求精神科治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Locked down or locked out? Trends in psychiatric emergency services utilization during the COVID-19 pandemic.

Objective: To estimate changes in Boston Emergency Services Team (BEST) psychiatric emergency services (PES) encounter volume (total and by care team) and inpatient disposition during the first 8 months of the COVID-19 pandemic.

Methods: Data on 30,657 PES encounters was extracted from the four-county, BEST reporting system. The study period consisted of the first 34 weeks of 2019 and 2020. This period corresponded to the first five stages of Massachusetts's COVID-19 public health restrictions: pre-lockdown, lockdown, Phase I, II and III reopenings. Descriptive and regression analyses were performed to estimate changes in encounter volume by care team and disposition.

Results: Compared to the same period in 2019, covariate-adjusted, weekly PES encounters decreased by 39% (β = -0.40, 95% Confidence Interval (CI) = [-0.51, -0.28], p < 0.00) during the lockdown. PES volume remained significantly lower during Phase I reopening compared to the previous year but returned to 2019 levels during Phase II. The covariate-adjusted proportion of weekly encounters that led to inpatient admission significantly increased by 16% (CI = [0.11, 0.21], p < 0.00) for mobile crisis teams (MCTs) and significantly declined by 13% (CI = [-0.19, -0.07], p < 0.00) for BEST-designated emergency departments during the lockdown period compared to the prior year.

Conclusions: The overall drop in PES utilization and the rise in inpatient admissions for MCT encounters suggests that during the early phases of the pandemic, patients delayed psychiatric care until they had a psychiatric crisis. Public health messaging about the lockdowns and absent equivalent messaging about the availability of telehealth services may have made patients more reluctant to seek psychiatric care.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
4.40
自引率
4.20%
发文量
39
期刊介绍: Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.
期刊最新文献
How can specialist investigation agencies inform system-wide learning for patient safety? A qualitative study of perspectives on the early years of the English healthcare safety investigation branch. What can the era of big data and big data analytics mean for health services research? Collaborative and integrated working between general practice and community pharmacies: A realist review of what works, for whom, and in which contexts. Public perspectives on the benefits and harms of lung cancer screening: A systematic review and mixed-method integrative synthesis. Rapid evidence assessment of student-assisted assessment and brief intervention clinics: Addressing the gaps in rural and remote health care.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1