PDF(Pubmed)
Abstract：
BACKGROUND: The deployment of the mental health nurse, an additional healthcare provider for individuals in need of mental healthcare in Dutch general practices, was expected to substitute treatments from general practitioners and providers in basic and specialized mental healthcare (psychologists, psychotherapists, psychiatrists, etc.). The goal of this study was to investigate the extent to which the degree of mental health nurse deployment in general practices is associated with healthcare utilization patterns of individuals with depression.
METHODS: We combined national health insurers\' claims data with electronic health records from general practices. Healthcare utilization patterns of individuals with depression between 2014 and 2019 (N = 31,873) were analysed. The changes in the proportion of individuals treated after depression onset were assessed in association with the degree of mental health nurse deployment in general practices.
RESULTS: The proportion of individuals with depression treated by the GP, in basic and specialized mental healthcare was lower in individuals in practices with high mental health nurse deployment. While the association between mental health nurse deployment and consultation in basic mental healthcare was smaller for individuals who depleted their deductibles, the association was still significant. Treatment volume of general practitioners was also lower in practices with higher levels of mental health nurse deployment.
CONCLUSIONS: Individuals receiving care at a general practice with a higher degree of mental health nurse deployment have lower odds of being treated by mental healthcare providers in other healthcare settings. More research is needed to evaluate to what extent substitution of care from specialized mental healthcare towards general practices might be associated with waiting times for specialized mental healthcare.
METHODS: We combined national health insurers\' claims data with electronic health records from general practices. Healthcare utilization patterns of individuals with depression between 2014 and 2019 (N = 31,873) were analysed. The changes in the proportion of individuals treated after depression onset were assessed in association with the degree of mental health nurse deployment in general practices.
RESULTS: The proportion of individuals with depression treated by the GP, in basic and specialized mental healthcare was lower in individuals in practices with high mental health nurse deployment. While the association between mental health nurse deployment and consultation in basic mental healthcare was smaller for individuals who depleted their deductibles, the association was still significant. Treatment volume of general practitioners was also lower in practices with higher levels of mental health nurse deployment.
CONCLUSIONS: Individuals receiving care at a general practice with a higher degree of mental health nurse deployment have lower odds of being treated by mental healthcare providers in other healthcare settings. More research is needed to evaluate to what extent substitution of care from specialized mental healthcare towards general practices might be associated with waiting times for specialized mental healthcare.
摘要：
背景：心理健康护士的部署，为需要荷兰一般实践中的精神保健的个人提供额外的医疗保健提供者，预计将替代基础和专业精神保健领域的全科医生和提供者的治疗(心理学家，心理治疗师,精神病医生,等。).这项研究的目的是调查一般实践中心理健康护士部署的程度与抑郁症患者的医疗保健利用模式相关的程度。
方法：我们将国家健康保险公司的索赔数据与一般实践中的电子健康记录相结合。分析了2014年至2019年抑郁症患者的医疗保健利用模式(N=31,873)。根据一般实践中心理健康护士的部署程度，评估了抑郁症发作后接受治疗的个体比例的变化。
结果：接受全科医生治疗的抑郁症患者的比例，在基础和专业精神卫生保健中，在具有高精神卫生护士部署的实践中，个体的比例较低。虽然精神卫生护士部署与基本精神卫生保健咨询之间的关联对于耗尽免赔额的个人而言较小，协会仍然很重要。在心理健康护士部署水平较高的情况下，全科医生的治疗量也较低。
结论：在普通实践中接受护理的个人，在其他医疗保健环境中接受精神保健提供者治疗的可能性较低。需要更多的研究来评估从专业精神保健到一般实践的替代护理在多大程度上可能与专业精神保健的等待时间相关。
方法：我们将国家健康保险公司的索赔数据与一般实践中的电子健康记录相结合。分析了2014年至2019年抑郁症患者的医疗保健利用模式(N=31,873)。根据一般实践中心理健康护士的部署程度，评估了抑郁症发作后接受治疗的个体比例的变化。
结果：接受全科医生治疗的抑郁症患者的比例，在基础和专业精神卫生保健中，在具有高精神卫生护士部署的实践中，个体的比例较低。虽然精神卫生护士部署与基本精神卫生保健咨询之间的关联对于耗尽免赔额的个人而言较小，协会仍然很重要。在心理健康护士部署水平较高的情况下，全科医生的治疗量也较低。
结论：在普通实践中接受护理的个人，在其他医疗保健环境中接受精神保健提供者治疗的可能性较低。需要更多的研究来评估从专业精神保健到一般实践的替代护理在多大程度上可能与专业精神保健的等待时间相关。
