在COVID-19之前、期间和之后，精神分裂症或相关疾病和双相情感障碍的急性卫生保健利用

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-06-01 DOI:10.1016/j.jemermed.2024.12.006

Luis A. Ornelas BS, Gary M. Vilke MD, Jesse J. Brennan MA, Melodie Santodomingo MPH, Edward M. Castillo PhD, MPH

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引用次数: 0

摘要

背景：急诊科（EDs）经常治疗急性精神健康问题患者，特别是重度精神疾病患者。本研究评估了加利福尼亚州精神分裂症和双相情感障碍患者在4年期间（包括COVID-19大流行期间）使用ED的趋势。目的：本研究旨在评估在COVID-19大流行之前、期间和之后，与重度精神障碍相关的急诊科就诊率、人口统计学特征和入院比例的变化。方法：对2018年至2021年18岁及以上重度精神分裂症患者的ED使用情况进行多中心回顾性分析，使用加州卫生保健获取与信息部ED和住院出院患者数据库。使用《国际疾病分类》第十次修订代码确定与重度精神障碍相关的就诊。人口统计变量包括年龄、性别、种族和民族、预期付款人和地理区域。结果：2018 - 2019年急诊总访问量呈上升趋势，2020年和2021年有所下降。从2019年到2020年，每10万次访问中与smi相关的ED次数有所增加，并在2021年保持上升。25-44岁的患者、非西班牙裔黑人个体和医疗补助受益人显示出最高的重度精神障碍相关ED使用率。洛杉矶县在地理区域中一直是最高的。结论：尽管在2019冠状病毒病大流行期间急诊科就诊人数总体减少，但与重度精神障碍相关的就诊人数增加，这表明急诊科对心理健康资源的需求，特别是对弱势群体，如非西班牙裔黑人和社会经济地位较低的人群。

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Acute Health Care Utilization Among Schizophrenia or Related Conditions and Bipolar Disorder Before, During, and After COVID-19

Background

Emergency departments (EDs) often care for patients with acute mental health issues, especially patients with severe mental illness (SMI). This study assessed trends in ED utilization for patients with schizophrenia and bipolar disorder over a 4-year period in California, including during the COVID-19 pandemic.

Objective

This study aimed to assess changes in ED visit rates, demographic characteristics, and admission proportions for SMI-related visits before, during, and after COVID-19 pandemic.

Methods

A multicenter retrospective analysis of ED utilization among patients 18 years or older with SMI was conducted from 2018 to 2021, using California's Department of Health Care Access and Information ED and inpatient discharged databases. SMI-related visits were identified using International Classification of Diseases, 10^th Revision codes. Demographic variables included age, sex, race and ethnicity, expected payer, and geographic region.

Results

Total ED visits increased from 2018 to 2019, then decreased in 2020 and 2021. SMI-related ED visits per 100,000 visits increased from 2019 to 2020 and remained elevated in 2021. Patients aged 25–44 years, non-Hispanic Black individuals, and Medicaid beneficiaries demonstrated the highest SMI-related ED utilization rates. Los Angeles County consistently had the highest rates among geographic regions.

Conclusions

Despite an overall reduction in ED visits during the COVID-19 pandemic, SMI-related visits increased, demonstrating the need for mental health resources in EDs, specifically for vulnerable populations, such as non-Hispanic Black individuals and those with lower socioeconomic status.

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine