Variation in patient-sharing network characteristics of health care professionals treating different mental and substance use disorder patient sub-groups in primary care.

IF 2.5 4区 医学 Q2 PSYCHIATRY
Marko Elovainio, Laura Hietapakka, Mai Gutvilig, Ripsa Niemi, Kaisla Komulainen, Laura Pulkki-Råback, Visa Väisänen, Timo Sinervo, Christian Hakulinen
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Abstract

Background: Providing efficient and targeted services for patients with mental health problems requires efficient collaboration and coordination within healthcare providers, but measuring collaboration using traditional methods is challenging.

Aims: To explore the patient-sharing networks of professionals taking care of different groups of patients with mental or substance use disorders.

Method: We used data that covered adult patients' visits to the primary care service providers of seven municipalities in Finland during year 2021. Data included 8,217 patients (147,430 visits) with mental or substance use disorders who were treated by 1,566 health care professionals. We calculated descriptive network metrics to examine the connectivity of professionals in three different patient groups (patients with substance use disorders, psychotic disorders, and depressive disorders) and compared these characteristics to a network based on all patients. We also analyzed whether patient sharing was associated with the health care professionals' attributes (occupational group, municipality) using Exponential Random Graph Models (ERGM).

Results: Diagnosis-specific networks were denser and more connected compared to the all-patients network. Nurses were the most central occupation in all the diagnosis-specific networks and especially in the substance use disorder patients network. When examining all patients, two professionals were more likely to share patients when they belonged to the same occupational group. However, in the network with depressive disorder patients we found the opposite: professionals were more likely to share patients if they were of different occupational groups.

Conclusions: Patient-sharing networks within patients with a specific mental or substance use disorders are denser and more connected than networks based on all patients with mental or substance use disorders. In the substance use disorder patients network particularly, nurses were the most central occupation. Multi-professional connections were more likely in depressive disorder networks than in the all-patients network.

在初级保健中治疗不同精神和药物使用障碍亚群患者的医护专业人员的患者共享网络特征存在差异。
背景:为精神疾病患者提供高效且有针对性的服务需要医疗服务提供者之间的有效合作与协调,但使用传统方法来衡量合作情况具有挑战性:我们使用了 2021 年期间芬兰七个城市的初级医疗服务提供者为成年患者提供的就诊数据。数据包括 8,217 名精神或药物使用障碍患者(147,430 人次),他们接受了 1,566 名医疗专业人员的治疗。我们计算了描述性网络指标,以检查三个不同患者群体(药物使用障碍患者、精神障碍患者和抑郁障碍患者)中专业人员的连接性,并将这些特征与基于所有患者的网络进行比较。我们还利用指数随机图模型(ERGM)分析了患者共享是否与医护人员的属性(职业类别、城市)相关:结果:与所有患者网络相比,特定诊断网络更密集,连接更紧密。护士是所有特定诊断网络中最重要的职业,尤其是在药物使用障碍患者网络中。在对所有患者进行研究时,如果两名专业人员属于同一职业类别,则更有可能共享患者。然而,在抑郁障碍患者网络中,我们发现了相反的情况:如果专业人员属于不同的职业类别,则更有可能分享患者:结论:与所有精神障碍或药物滥用障碍患者的网络相比,特定精神障碍或药物滥用障碍患者的患者共享网络更为密集,联系更为紧密。特别是在药物使用障碍患者网络中,护士是最重要的职业。与所有患者网络相比,抑郁障碍患者网络中更有可能出现多职业联系。
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来源期刊
CiteScore
12.30
自引率
1.30%
发文量
120
期刊介绍: The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities. Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas. The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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