Nicholas Bowden PhD, Aaron Hedquist MSc, Dannie Dai BS., Olukorede Abiona PhD, Enrique Bernal-Delgado MD, PhD, Carl Rudolf Blankart PhD, Julie Cartailler MEcon, Francisco Estupiñán-Romero MD, MPH, Philip Haywood PhD, MBChB, Zeynep Or PhD, Irene Papanicolas PhD, Mai Stafford PhD, Steven Wyatt MPH, Reijo Sund PhD, Jean Pierre Uwitonze MSc, Walter P. Wodchis PhD, Robin Gauld PhD, Hien Vu MHEd, Tania Sawaya BS, Jose F. Figueroa MD, MPH
{"title":"高收入国家在 COVID-19 大流行之前和期间与精神健康状况有关的住院和急诊就诊情况的国际比较。","authors":"Nicholas Bowden PhD, Aaron Hedquist MSc, Dannie Dai BS., Olukorede Abiona PhD, Enrique Bernal-Delgado MD, PhD, Carl Rudolf Blankart PhD, Julie Cartailler MEcon, Francisco Estupiñán-Romero MD, MPH, Philip Haywood PhD, MBChB, Zeynep Or PhD, Irene Papanicolas PhD, Mai Stafford PhD, Steven Wyatt MPH, Reijo Sund PhD, Jean Pierre Uwitonze MSc, Walter P. Wodchis PhD, Robin Gauld PhD, Hien Vu MHEd, Tania Sawaya BS, Jose F. Figueroa MD, MPH","doi":"10.1111/1475-6773.14386","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To explore variation in rates of acute care utilization for mental health conditions, including hospitalizations and emergency department (ED) visits, across high-income countries before and during the COVID-19 pandemic.</p>\n </section>\n \n <section>\n \n <h3> Data Sources and Study Setting</h3>\n \n <p>Administrative patient-level data between 2017 and 2020 of eight high-income countries: Canada, England, Finland, France, New Zealand, Spain, Switzerland, and the United States (US).</p>\n </section>\n \n <section>\n \n <h3> Study Design</h3>\n \n <p>Multi-country retrospective observational study using a federated data approach that evaluated age-sex standardized rates of hospitalizations and ED visits for mental health conditions.</p>\n </section>\n \n <section>\n \n <h3> Principal Findings</h3>\n \n <p>There was significant variation in rates of acute mental health care utilization across countries. Among the subset of four countries with both hospitalization and ED data, the US had the highest pre-COVID-19 combined average annual acute care rate of 1613 episodes/100,000 people (95% CI: 1428, 1797). Finland had the lowest rate of 776 (686, 866). When examining hospitalization rates only, France had the highest rate of inpatient hospitalizations of 988/100,000 (95% CI 858, 1118) while Spain had the lowest at 87/100,000 (95% CI 76, 99). For ED rates for mental health conditions, the US had the highest rate of 958/100,000 (95% CI 861, 1055) while France had the lowest rate with 241/100,000 (95% CI 216, 265). Notable shifts coinciding with the onset of the COVID-19 pandemic were observed including a substitution of care setting in the US from ED to inpatient care, and overall declines in acute care utilization in Canada and France.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The study underscores the importance of understanding and addressing variation in acute care utilization for mental health conditions, including the differential effect of COVID-19, across different health care systems. Further research is needed to elucidate the extent to which factors such as workforce capacity, access barriers, financial incentives, COVID-19 preparedness, and community-based care may contribute to these variations.</p>\n </section>\n \n <section>\n \n <h3> What is known on this topic</h3>\n \n <div>\n <ul>\n \n <li>Approximately one billion people globally live with a mental health condition, with significant consequences for individuals and societies.</li>\n \n <li>Rates of mental health diagnoses vary across high-income countries, with substantial differences in access to effective care.</li>\n \n <li>The COVID-19 pandemic has exacerbated mental health challenges globally, with varying impacts across countries.</li>\n </ul>\n </div>\n </section>\n \n <section>\n \n <h3> What this study adds</h3>\n \n <div>\n <ul>\n \n <li>This study provides a comprehensive international comparison of hospitalization and emergency department visit rates for mental health conditions across eight high-income countries.</li>\n \n <li>It highlights significant variations in acute care utilization patterns, particularly in countries that are more likely to care for people with mental health conditions in emergency departments rather than inpatient facilities</li>\n \n <li>The study identifies temporal and cross-country differences in acute care management of mental health conditions coinciding with the onset of the COVID-19 pandemic.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":55065,"journal":{"name":"Health Services Research","volume":"59 6","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622279/pdf/","citationCount":"0","resultStr":"{\"title\":\"International comparison of hospitalizations and emergency department visits related to mental health conditions across high-income countries before and during the COVID-19 pandemic\",\"authors\":\"Nicholas Bowden PhD, Aaron Hedquist MSc, Dannie Dai BS., Olukorede Abiona PhD, Enrique Bernal-Delgado MD, PhD, Carl Rudolf Blankart PhD, Julie Cartailler MEcon, Francisco Estupiñán-Romero MD, MPH, Philip Haywood PhD, MBChB, Zeynep Or PhD, Irene Papanicolas PhD, Mai Stafford PhD, Steven Wyatt MPH, Reijo Sund PhD, Jean Pierre Uwitonze MSc, Walter P. Wodchis PhD, Robin Gauld PhD, Hien Vu MHEd, Tania Sawaya BS, Jose F. Figueroa MD, MPH\",\"doi\":\"10.1111/1475-6773.14386\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To explore variation in rates of acute care utilization for mental health conditions, including hospitalizations and emergency department (ED) visits, across high-income countries before and during the COVID-19 pandemic.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Data Sources and Study Setting</h3>\\n \\n <p>Administrative patient-level data between 2017 and 2020 of eight high-income countries: Canada, England, Finland, France, New Zealand, Spain, Switzerland, and the United States (US).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Study Design</h3>\\n \\n <p>Multi-country retrospective observational study using a federated data approach that evaluated age-sex standardized rates of hospitalizations and ED visits for mental health conditions.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Principal Findings</h3>\\n \\n <p>There was significant variation in rates of acute mental health care utilization across countries. Among the subset of four countries with both hospitalization and ED data, the US had the highest pre-COVID-19 combined average annual acute care rate of 1613 episodes/100,000 people (95% CI: 1428, 1797). Finland had the lowest rate of 776 (686, 866). When examining hospitalization rates only, France had the highest rate of inpatient hospitalizations of 988/100,000 (95% CI 858, 1118) while Spain had the lowest at 87/100,000 (95% CI 76, 99). For ED rates for mental health conditions, the US had the highest rate of 958/100,000 (95% CI 861, 1055) while France had the lowest rate with 241/100,000 (95% CI 216, 265). 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International comparison of hospitalizations and emergency department visits related to mental health conditions across high-income countries before and during the COVID-19 pandemic
Objective
To explore variation in rates of acute care utilization for mental health conditions, including hospitalizations and emergency department (ED) visits, across high-income countries before and during the COVID-19 pandemic.
Data Sources and Study Setting
Administrative patient-level data between 2017 and 2020 of eight high-income countries: Canada, England, Finland, France, New Zealand, Spain, Switzerland, and the United States (US).
Study Design
Multi-country retrospective observational study using a federated data approach that evaluated age-sex standardized rates of hospitalizations and ED visits for mental health conditions.
Principal Findings
There was significant variation in rates of acute mental health care utilization across countries. Among the subset of four countries with both hospitalization and ED data, the US had the highest pre-COVID-19 combined average annual acute care rate of 1613 episodes/100,000 people (95% CI: 1428, 1797). Finland had the lowest rate of 776 (686, 866). When examining hospitalization rates only, France had the highest rate of inpatient hospitalizations of 988/100,000 (95% CI 858, 1118) while Spain had the lowest at 87/100,000 (95% CI 76, 99). For ED rates for mental health conditions, the US had the highest rate of 958/100,000 (95% CI 861, 1055) while France had the lowest rate with 241/100,000 (95% CI 216, 265). Notable shifts coinciding with the onset of the COVID-19 pandemic were observed including a substitution of care setting in the US from ED to inpatient care, and overall declines in acute care utilization in Canada and France.
Conclusion
The study underscores the importance of understanding and addressing variation in acute care utilization for mental health conditions, including the differential effect of COVID-19, across different health care systems. Further research is needed to elucidate the extent to which factors such as workforce capacity, access barriers, financial incentives, COVID-19 preparedness, and community-based care may contribute to these variations.
What is known on this topic
Approximately one billion people globally live with a mental health condition, with significant consequences for individuals and societies.
Rates of mental health diagnoses vary across high-income countries, with substantial differences in access to effective care.
The COVID-19 pandemic has exacerbated mental health challenges globally, with varying impacts across countries.
What this study adds
This study provides a comprehensive international comparison of hospitalization and emergency department visit rates for mental health conditions across eight high-income countries.
It highlights significant variations in acute care utilization patterns, particularly in countries that are more likely to care for people with mental health conditions in emergency departments rather than inpatient facilities
The study identifies temporal and cross-country differences in acute care management of mental health conditions coinciding with the onset of the COVID-19 pandemic.
期刊介绍：
Health Services Research (HSR) is a peer-reviewed scholarly journal that provides researchers and public and private policymakers with the latest research findings, methods, and concepts related to the financing, organization, delivery, evaluation, and outcomes of health services. Rated as one of the top journals in the fields of health policy and services and health care administration, HSR publishes outstanding articles reporting the findings of original investigations that expand knowledge and understanding of the wide-ranging field of health care and that will help to improve the health of individuals and communities.
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