BUSCAR CUIDEN SUMMA CUIDEN CANTARIDA

Resumen

Introducción: Un fenómeno muy estudiado en salud mental son los ingresos hospitalarios. Existe relación entre situaciones como la falta de adhesión y los ingresos hospitalarios: a menor adhesión a los cuidados, mayor es el riesgo de sufrir una descompensación y un ingreso hospitalario. Objetivos: Analizar patrones de uso de servicios de salud mental de personas diagnosticadas de esquizofrenia en función de variables sociodemográficas (área sanitaria, edad y sexo). Método: Estudio observacional analítico. Se analiza la tasa de ingreso hospitalario relacionándola con el sexo, la edad y el área sanitaria de referencia, entre 1995 y 2005. El análisis estadístico se ha realizado mediante tablas de contingencia y chi-cuadrado. Resultados: Encontramos relación estadísticamente significativa entre el uso de servicios hospitalarios y la edad y el sexo de la persona atendida, así como entre ese uso de recursos hospitalarios en general y el número de ingresos agudos en particular con el área sanitaria.
Palabras clave: Continuidad de cuidados/ Esquizofrenia/ Uso de servicios sanitarios.

Abstract (Analysis of the use of mental health services based on the demographic characteristics of people diagnosed with schizophrenia)

Introduction: The hospital admission is one of the most studied processes in the mental health services. There is a correlation between the non-compliance conduct and the admission in a hospital service. The aim of this article is to analyse the utilization of mental health services by persons diagnosed of schizophrenia in order to socio-demographic factors. Method: Observational study. We analyse the hospital admission establishing its relation with the place of residence, the sex and the age in a sample of persons diagnosed of schizophrenia living in Madrid from 1995 to 2005. The statistical analysis was made by cross-tabs and chi square. Results: We found correlation between the utilization of mental health services and the sex and the age of individuals diagnosed of schizophrenia, as well as between the place of residence and the utilization of mental health services in general and the hospital admission specifically.
Key-words: Continuity of care/ Schizophrenia/ Health services utilization.

Bibliografía

1. Asociación Nacional de Enfermería de Salud Mental. La Reforma Psiquiátrica en España, evolución y futuro de los cuidados enfermeros en salud mental. Madrid: ANESM; 2009.
2. Pacheco Borrella G. Elementos implicados en la construcción social enfermo mental. In: Pacheco Borrella G, editor. La construcción social enfermo mental Su repercusión en el individuo, familia y en los cuidados de salud mental. 1st ed. Editorial Académica Española; 2013. p. 52-174.
3. Megías Lizancos F, Pacheco Borrella G. Intervenciones enfermeras en el ámbito de la salud mental comunitaria. In: Megías Lizancos F, Serrano Parra MD, editors. Enfermería en psiquiatría y salud mental. España: DAE; 2009. p. 348-467.
4. Comisión Ministerial para la Reforma Psiquiátrica. Documento general y recomendaciones para la reforma psiquiátrica y la atención a la salud mental. Rev la Asoc Española Neuropsiquiatría. 1985;V(13):204-22.
5. Prince JD. Practices preventing rehospitalization of individuals with schizophrenia. J Nerv Ment Dis. Rutgers: The State University of New Jersey, School of Social Work, New Brunswick, New Jersey 08901-1167, USA.; 2006;194(6):397-403.
6. Hendrie HC, Lindgren D, Hay DP, Lane KA, Gao S, Purnell C, et al. Comorbidity profile and healthcare utilization in elderly patients with serious mental illnesses. Am J Geriatr Psychiatry. Indiana University School of Medicine, Indianapolis; Indiana University Center for Aging Research, Indianapolis; Regenstrief Institute Inc., Indianapolis; Indiana University Department of Psychiatry, Indianapolis. Electronic address: hhendri@iupui.edu.: American Association for Geriatric Psychiatry. Published by Elsevier Inc; 2013;21(12):1267-76.
7. Hendrie HC, Tu W, Tabbey R, Purnell CE, Ambuehl RJ, Callahan CM. Health outcomes and cost of care among older adults with schizophrenia: a 10-year study using medical records across the continuum of care. Am J Geriatr Psychiatry. Indiana University School of Medicine, Indianapolis, IN; Indiana University Center for Aging Research, Indianapolis, IN; Regenstrief Institute, Inc., Indianapolis, IN; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN. Elec: American Association for Geriatric Psychiatry. Published by Elsevier Inc; 2014;22(5):427-36.
8. Valenstein M, Copeland LA, Blow FC, McCarthy JF, Zeber JE, Gillon L, et al. Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Med Care. From the Department of Veterans Affairs, Serious Mental Illness Treatment, Research, and Evaluation Center (SMITREC), Health Services Research and Development (HSR&D) Center for Excellence, Ann Arbor, MI 48113-0170, USA. marciav@umich.edu; 2002;40(8):630-9.
9. Berghofer G, Schmidl F, Rudas S, Steiner E, Schmitz M. Predictors of treatment discontinuity in outpatient mental health care. Soc Psychiatry Psychiatr Epidemiol. Kuratorium fur Psychosoziale Dienste, Mariannengasse 1/15, 1090 Vienna, Austria. psd-quasi@netway.at; 2002;37(6):276-82.
10. Hunt GE, Bergen J, Bashir M. Medication compliance and comorbid substance abuse in schizophrenia: impact on community survival 4 years after a relapse. Schizophr Res. Department of Psychological Medicine, University of Sydney, Rozelle Hospital, P.O. Box 1, N.S.W., 2039, Rozelle, Australia. ghunt@mail.usyd.edu.au; 2002;54(3):253-64.
11. Maples NJ, Copeland LA, Zeber JE, Li X, Moore TA, Dassori A, et al. Can medication management coordinators help improve continuity of care after psychiatric hospitalization? Psychiatr Serv. Department of Psychiatry, Division of Schizophrenia and Related Disorders, UT Health Science Center San Antonio, 7703 Floyd Curl Dr., MS 7797, San Antonio, TX 78229, USA. maplesn@uthscsa.edu; 2012;63(6):554-60.
12. Brekke JS, Ansel M, Long J, Slade E, Weinstein M. Intensity and continuity of services and functional outcomes in the rehabilitation of persons with schizophrenia. Psychiatr Serv. School of Social Work, University of Southern California, Los Angeles 90089-0411, USA. brekke@usc.edu; 1999;50(2):248-56.
13. Craig TJ, Fennig S, Tanenberg-Karant M, Bromet EJ. Rapid versus delayed readmission in first-admission psychosis: quality indicators for managed care? Ann Clin Psychiatry. Bronx Veterans Administration Medical Center, New York, USA.; 2000;12(4):233-8.
14. Druss BG, Rosenheck RA, Stolar M. Patient satisfaction and administrative measures as indicators of the quality of mental health care. Psychiatr Serv. Veterans Administration Northeast Program Evaluation Center, West Haven, CT 06516, USA. benjamin.druss@yale.edu; 1999;50(8):1053-8.
15. Gupta S, Hendricks S, Kenkel AM, Bhatia SC, Haffke EA. Relapse in schizophrenia: is there a relationship to substance abuse? Schizophr Res. Omaha VA Medical Center, NE 68105, USA.; 1996;20(1-2):153-6.
16. Haywood TW, Kravitz HM, Grossman LS, Cavanaugh Jr JL, Davis JM, Lewis DA. Predicting the "revolving door" phenomenon among patients with schizophrenic, schizoaffective, and affective disorders. Am J Psychiatry. Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Ill.; 1995;152(6):856-61.
17. Olfson M, Mechanic D, Boyer CA, Hansell S. Linking inpatients with schizophrenia to outpatient care. Psychiatr Serv. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute 10032, USA. olfsonm@child.cpmc.columbia.edu; 1998;49(7):911-7.
18. Olfson M, Mechanic D, Boyer CA, Hansell S, Walkup J, Weiden PJ. Assessing clinical predictions of early rehospitalization in schizophrenia. J Nerv Ment Dis. New York State Psychiatric Institute/Department of Psychiatry, College of Physicians & Surgeons of Columbia University, New York 10032, USA.; 1999;187(12):721-9.
19. Ries RK, Russo J, Wingerson D, Snowden M, Comtois KA, Srebnik D, et al. Shorter hospital stays and more rapid improvement among patients with schizophrenia and substance disorders. Psychiatr Serv. Department of Psychiatry and Behavioral Sciences, The University of Washington School of Medicine at Haborview Medical Center, Seattle, Washington 98104, USA. rries@u.washington.edu; 2000;51(2):210-5.
20. Prince JD. Practices Preventing Rehospitalization of Individuals With Schizophrenia. J Nerv Ment Dis [Internet]. Rutgers State University of New Jersey, School of Social Work, New Brunswick, NJ, US?; Prince, Jonathan D.,536 George Street,New Brunswick,US,08901-1167,Rutgers State University of New Jersey, School of Social Work: Lippincott Williams & Wilkins; 2006 [Consultado el 20.3.2014];194(6):397-403. Disponible en: https://lw3ne3md9a.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&rfr_id=info:sid/ProQ%253Apsycinfo&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.jtitle=Journal+of+Nervous+and+Mental+Disease&rft.atitle=Practice
21. Papageorgiou G, Canas F, Zink M, Rossi A. Country differences in patient characteristics and treatment in schizophrenia: data from a physician-based survey in Europe. Eur Psychiatry. France; 2011 Mar;26(1 Suppl 1):17-28.
22. Aizpuru F, Latorre K, Pérez de Arriba J, Mosquera F, Bernal-Delgado E. Variabilidad en la tasa de hospitalizaciones por problemas de Salud Mental en centros hospitalarios de agudos. Atlas Variaciones la Práctica Médica. 2008;3(1):199-216.
23. Ministerio de Sanidad PS e I. Estrategia en Salud Mental del Sistema Nacional de Salud. 2009.
24. Hafner H, Maurer K, Loffler W, Riecher-Rossler A. The influence of age and sex on the onset and early course of schizophrenia. Br J Psychiatry. Central Institute of Mental Health, Mannheim, Germany.; 1993;162:80-6.
25. Adair CE, McDougall GM, Mitton CR, Joyce AS, Wild TC, Gordon A, et al. Continuity of care and health outcomes among persons with severe mental illness. Psychiatr Serv. Department of psychiatry, University of Calgary, 3330 Hospital Drive, N.W., Calgary, Alberta, Canada T2N 4N1. ceadair@ucalgary.ca; 2005;56(9):1061-9.
26. Bachrach LL. Continuity of care for chronic mental patients: a conceptual analysis. Am J Psychiatry. UNITED STATES; 1981;138(11):1449-56.
27. World Health Organization. Psychiatric case registers. Report on a working group. Copenhagen; 1983.
28. Beguiristain JM, Arrazola A, Elizalde B, Alkiza ME. [Singularization processes: a proposal for continuity between clinical activity and health policy objectives]. Gac Sanit. Spain; 2005;19(2):168-71.
29. Hansson L, Sandlund M. Utilization and patterns of care in comprehensive psychiatric care organizations. A review of studies and some methodological considerations. Acta Psychiatr Scand. DENMARK; 1992 Oct;86(4):255-61.
30. Hobbs P, Deavoll B, Abernethy P. Psychiatric service use: a cohort study of first attenders. Acta Psychiatr Scand. DENMARK; 1992 Oct;86(4):313-9.
31. Sajatovic M, Vernon L, Semple W. Clinical characteristics and health resource use of men and women veterans with serious mental illness. Psychiatr Serv. UNITED STATES; 1997 Nov;48(11):1461-3.
32. Friedman JI, Harvey PD, Coleman T, Moriarty PJ, Bowie C, Parrella M, et al. Six-year follow-up study of cognitive and functional status across the lifespan in schizophrenia: a comparison with Alzheimer's disease and normal aging. Am J Psychiatry. United States; 2001 Sep;158(9):1441-8.
33. Horan WP, Goldstein G. A retrospective study of premorbid ability and aging differences in cognitive clusters of schizophrenia. Psychiatry Res. Ireland; 2003 Jun;118(3):209-21.
34. Ginsberg G, Lerner Y, Mark M, Popper M. Prior hospitalization and age as predictors of mental health resource utilization in Israel. Soc Sci Med. ENGLAND; 1997 Mar;44(5):623-33.
35. Fontanella CA, Guada J, Phillips G, Ranbom L, Fortney JC. Individual and contextual-level factors associated with continuity of care for adults with schizophrenia. Adm Policy Ment Health. Department of Psychiatry, The Ohio State University, 1670 Upham Drive, Columbus, OH, 43210, USA, fontanella.4@osu.edu.; 2014;41(5):572-87.
36. Whitehead M. The concepts and principles of equity and health. Int J Health Serv. UNITED STATES; 1992;22(3):429-45.
37. Novakovic V, Barkin RL, Hamner MB, LeClear O'Connell K. Schizophrenia: improving the continuity of care to ensure optimal patient outcomes. Dis Mon. Department of Psychiatry, James J. Peters VA Medical Center, Mount Sinai School of Medicine, Bronx, New York, USA.; 2012;58(7):395-409.
38. Van Duin D, Franx G, Van Wijngaarden B, Van Der Gaag M, Van Weeghel J, Slooff C, et al. Bridging the science-to-service gap in schizophrenia care in the Netherlands: the Schizophrenia Quality Improvement Collaborative. Int J Qual Health Care. Trimbos-instituut, PO Box 725, 3500 AS Utrecht, The Netherlands. dduin@trimbos.nl.; 2013;25(6):626-32.

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