将社区精神卫生服务的频繁服务使用者分配到不同护理包的预测模型

L. Grigoletti, F. Amaddeo, A. Grassi, M. Boldrini, M. Chiappelli, M. Percudani, F. Catapano, A. Fiorillo, F. Perris, M. Bacigalupi, P. Albanese, Simona Simonetti, P. De Agostini, M. Tansella
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引用次数: 8

摘要

目的:开发预测模型,在意大利社区精神卫生服务(cmhs)内将患者分配到频繁和低服务使用者群体。将频繁使用者分配到不同的一揽子保健服务,确定这些一揽子保健服务的费用。方法-收集了5家cmhs的1250名用户的社会人口统计学和临床数据以及基线GAF评分。这些患者在6个月内的所有精神病学接触都被记录下来。逻辑回归确定了频繁服务用户的预测变量。多项逻辑回归确定了能够预测最合适的护理方案的变量。成本函数被用来估计成本。结果-频繁服务用户占49%,使用了近90%的联系人。该模型在频繁用户组和低用户组中正确分类了80%的用户。确定了三个护理包:基本社区治疗(每六个月4,133欧元);密集社区治疗(6180欧元)和康复社区治疗(11984欧元)分别用于83%、6%和11%的频繁服务使用者。该模型被发现对85%的用户是准确的。结论:有可能开发预测模型来识别频繁的服务用户,并将他们分配到预定义的护理包中,并使用这些模型来通知精神病学护理的资金。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A predictive model to allocate frequent service users of community-based Mental Health Services to different packages of care
Summary Aim – To develop predictive models to allocate patients into frequent and low service users groups within the Italian Community-based Mental Health Services (CMHSs). To allocate frequent users to different packages of care, identifing the costs of these packages. Methods – Socio-demographic and clinical data and GAF scores at baseline were collected for 1250 users attending five CMHSs. All psychiatric contacts made by these patients during six months were recorded. A logistic regression identified frequent service users predictive variables. Multinomial logistic regression identified variables able to predict the most appropriate package of care. A cost function was utilised to estimate costs. Results – Frequent service users were 49%, using nearly 90% of all contacts. The model classified correctly 80% of users in the frequent and low users groups. Three packages of care were identified: Basic Community Treatment (4,133 Euro per six months); Intensive Community Treatment (6,180 Euro) and Rehabilitative Community Treatment (11,984 Euro) for 83%, 6% and 11% of frequent service users respectively. The model was found to be accurate for 85% of users. Conclusion – It is possible to develop predictive models to identify frequent service users and to assign them to pre-defined packages of care, and to use these models to inform the funding of psychiatric care.
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