Report Calls for Sweeping Changes in Health Care for Mental and Substance Abuse Problems

2007 ◽  
Keyword(s):  
Health Care ◽  
Substance Abuse

scholarly journals Comparison of data sources on alcohol problems: An exploratory exercise using surveys vs. national healthcare registers

2020 ◽  
pp. 145507252096802
Author(s):  
Pia Mäkelä ◽  
Kristiina Kuussaari ◽  
Airi Partanen ◽  
Elina Rautiainen
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Healthcare Service ◽  
Service Use ◽  
Basic Education ◽  
Alcohol Problems ◽  
Register Data ◽  
Data Sources ◽  
National Healthcare ◽  
Healthcare Service Use

Aims: Both survey and healthcare register data struggle as data sources to capture the phenomenon of alcohol problems. We study a large group of people for whom survey data and two types of register data are available, and examine the overlaps of similar or related measures in the different data sources to learn about potential weaknesses in each. We also examine how register-based data on the prevalence of alcohol problems change depending on which register data are used. Design: We use data from the Regional Health and Wellbeing Study (ATH) of the adult Finnish population collected in 2013 and 2014 ( n = 69,441), individually linked with data on two national healthcare registers (Care Register for Health Care; Register of Primary Health Care visits) for the survey year and previous year. Results: The prevalence of substance-abuse-related healthcare was almost two-fold if data on outpatient primary care visits were included in addition to hospitalisations. Forty-six per cent of the survey respondents self-reporting substance-abuse-related healthcare service use were identified in the registers, and 22% of all respondents with such service use according to registers reported this in the survey. Records of substance-abuse-related healthcare service use, controlled for self-reported alcohol use and self-reported substance-abuse-related service use, were found more often for men, the middle-aged, people with basic education only, and the non-employed. Conclusions: The results are suggestive of underreporting in both data sources. There is an evident need to develop recording practices in the healthcare registers regarding substance use disorders.

Clinical Predictors for Unsafe Direct Discharge Home Patients From Intensive Care Units

2018 ◽  
Vol 35 (10) ◽  
pp. 1067-1073
Author(s):  
Vincent Issac Lau ◽  
Fran Priestap ◽  
Joyce N. H. Lam ◽  
John Basmaji ◽  
Ian M. Ball
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Care Facility ◽  
Health Care Facility ◽  
Surgical Trauma ◽  
Home Discharge ◽  
Return Visits

Purpose: To describe factors (demographics and clinical characteristics) that predict patients who are at an increased risk of adverse events or unplanned return visits to a health-care facility following discharge direct to home (DDH) from intensive care units (ICUs). Methods: Prospective cohort study of all adult patients who survived their stay in our medical–surgical–trauma ICU between February 2016 and 2017 and were discharged directly home. Patients were followed for 8 weeks postdischarge. Univariable and multivariable logistic regression analyses were performed to identify factors associated with adverse events or unplanned return visits to a health-care facility following DDH from ICU. Results: A total of 129 DDH patients were enrolled and completed the 8-week follow-up. We identified 39 unplanned return visits (URVs). There was 0% mortality at 8 weeks postdischarge. Eight potential predictors of hospital URVs ( P < .2) were identified in the univariable analysis: prior substance abuse (odds ratio [OR] of URV of 2.50 [95% confidence interval: 1.08-5.80], hepatitis (OR: 6.92 [1.68-28.48]), sepsis (OR: 11.03 [1.19-102.29]), admission nine equivalents of nursing manpower score (NEMS) <24 (OR: 2.28 [1.03-5.04], no fixed address (OR: 22.9 [1.2-437.3]), ICU length of stay (LOS) <2 days (OR: 2.95 [1.28-6.78]), home discharge within London, Ontario (OR: 2.44 [1.00-5.92]), and left against medical advice (AMA; OR: 6.06 [2.04-17.98]). Conclusions: Our study identified 8 covariates that were potential predictors of URV: prior substance abuse, hepatitis, sepsis, admission NEMS <24, no fixed address, ICU LOS <2 days, home discharge within London, Ontario, and left AMA. The practice of direct discharges home from the ICU would benefit from adequately powered multicenter study in order to construct a clinical prediction model (that would require further testing and validation).

Susceptibility to Environmental Pollutants among Minorities

1993 ◽  
Vol 9 (5) ◽  
pp. 797-820 ◽  
Author(s):  
Richard Rios ◽  
Gerald V. Poje ◽  
Roger Detels
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Health Status ◽  
Communication Skills ◽  
Access To Health Care ◽  
Minority Groups ◽  
Environmental Pollutants ◽  
Health Care Education ◽  
Access To Health ◽  
Genetic Makeup

Susceptibility to environmental pollutants involves both biological and nonbiobgical factors. Individuals belonging to minority groups are much more likely to be subject to a number of these factors. This paper examines biological susceptibility of minorities to environmental pollutants and provides specific examples of susceptibility resulting from: genetic makeup; occupation; other factors such as compromised health status, exposure to mixtures of pollutants, substance abuse, and unemployment; and social inequality of access to health care, education, and communication skills. Recommendations are made for specific actions and for additional studies.

scholarly journals Características sociodemográficas de las personas admitidas en un centro hospitalario psiquiátrico alemán: un estudio retrospectivo.

2020 ◽  
pp. 4-10
Author(s):  
Blanca Patricia Silva-Barrera ◽  
Rocio Juliá-Sanchis ◽  
Andrés Montoyo-Guijarro ◽  
Rosa Requena-Morales
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Substance Abuse ◽  
Retrospective Study ◽  
Mental Disorders ◽  
Psychiatric Hospital ◽  
Psychiatric Symptoms ◽  
Clinical History ◽  
Severe Mental Disorders ◽  
Salud Mental

Resumen En los últimos años se han suscitado cambios en la salud mental de las personas, debido a las diversas problemáticas sociodemográficas actuales. Se requiere de la exploración de los acontecimientos que causan síntomas psiquiátricos en las personas con necesidad de ingreso y hospitalización. Es por eso que se realizó este estudio retrospectivo sobre 1.593 historias clínicas del hospital psiquiátrico Main-Kinzig-Kreis Schlüchtern en Alemania durante el período 2000-2014 en pacientes de 18 a 69 años. Se identificó como motivo de ingreso a un 37.16% de personas como pacientes con síntomas agudos, una relación con consumos de sustancias provocadas por adicciones en un 41.62% y el trastorno depresivo en un 28.75%. Se detecta la descompensación de trastornos mentales graves en 27.05%, en donde el 34.71% de los pacientes fueron derivadas desde otros dispositivos asistenciales y el 32.89% decidió ingresar por sí mismo. El perfil del paciente ingresado es de ser hombre entre 41-50 años, casado o con pareja, derivado por recurso asistencial relacionado con la descompensación de un trastorno mental grave. Abstract In recent years, changes have occurred in people&#39;s mental health due to various current socio- demographic issues. The exploration of the events that cause psychiatric symptoms in people who need admission and hospitalization is required. That is why this retrospective study was conducted on 1.593 clinical history from the Main-Kinzig-Kreis Schlüchtern psychiatric hospital in Germany during the period 2000-2014 in patients aged 18 to 69. A total of 37.16% of the patients were identified as having acute symptoms, 41.62% as having substance abuse due to addiction and 28.75% as having a depressive disorder. Decompensation of severe mental disorders was detected in 27.05%, where 34.71% of the patients were referred from other care devices and 32.89% decided to be admitted on their own. The profile of the admitted patient is a man between 41-50 years old, married or with a partner, referred to the psychiatric hospital for health care resources due to a decompensation of some serious mental disorder.

The importance of spiritual assessment when caring for older adults

2014 ◽  
Vol 36 (1) ◽  
pp. 1-16 ◽  
Author(s):  
ANN HARRINGTON
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Substance Abuse ◽  
Mental Illness ◽  
Social Work ◽  
Assessment Tools ◽  
Care Giver ◽  
Spiritual Assessment ◽  
Positive Effects ◽  
Growing Body

ABSTRACTThere is a growing body of literature documenting the positive effects of both religiousness and spirituality on human health, particularly among those who are ageing or diagnosed with a life-limiting illness. These positive effects provide buffers to life's stressors such as those associated with mental illness, care-giver burden, substance abuse and social disruption resulting from war. An important aspect of health care for individuals of all ages involves completion of a spiritual assessment. This paper explores the concept of spirituality and spiritual assessment, which has many definitions in the literature, and also provides examples of assessment tools from theology, nursing, social work and medicine.

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