Mental health hospitalizations and follow-up care in autistic adults

成人自闭症患者的心理健康住院治疗和后续护理

基本信息

批准号：
10742562
负责人：
Jessica Emmalee Rast
金额：
$ 15.15万
依托单位：
DREXEL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-15 至 2025-08-14
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10742562
关键词：
ASD patient Address Adult Anxiety Caring Characteristics Communities Community Participation Complex Continuity of Patient Care Dangerous Behavior Data Databases Diagnosis Emergency Situation Enrollment Environment Event Feeling Future General Population Goals Guidelines Health Health Care Costs Health Personnel Health Services Accessibility Health system Healthcare Healthcare Systems High Prevalence Hospitalization Hospitals Inpatients Investigation Knowledge Lead Literature Location Maintenance Mediation Medicaid Mental Depression Mental Health Mental Health Services Modality Mood Disorders Outcome Outpatients Patients Pattern Patterns of Care Persons Pharmaceutical Preparations Play Population Prevalence Preventive care Provider Quality of Care Quality of life Recommendation Records Recurrence Reporting Research Research Personnel Resources Risk Role Schizophrenia Sensory Services Severities Social support Source Strategic Planning Symptoms System Time Training Visit adult with autism spectrum disorder autism spectrum disorder autistic barrier to care base care costs care delivery care systems coping cost design diagnostic signature evidence base experience follow-up health care delivery health management health service use hospital readmission improved individuals with autism spectrum disorder medical specialties mortality non-compliance peer prevent service delivery social stigma symptom management tool

项目摘要

PROJECT ABSTRACT Autistic adults experience higher rates of co-occurring mental health conditions than their peers, impacting quality of life and increasing the complexity and cost of health care. Experiences of adversity, isolation, and stigma may place autistic people at increased risk for mental health concerns. Mental health services can play a key role in supporting people to cope with mental health concerns. When mental health is not adequately addressed, issues frequently escalate to crisis level and treatable mental health conditions become more severe and disabling over time. While there is no centralized system mental health crisis system in the U.S., emergency and inpatient hospitalization is an integral part of crisis care for many people. There is limited understanding of hospitalization in autistic adults, but preliminary findings suggest mental health conditions, including mood disorders and schizophrenia, are among the most common reasons for inpatient hospitalization in autistic adults. While hospitals are a common source of emergency and crisis care for mental health, they are often not equipped to provide quality care. This is a problem amplified in autistic patients because of lack of provider knowledge of autism, high prevalence of multiple co-occurring conditions, and autism characteristics complicating care including sensory sensitivity and difficulty with new routines and unknown places. Therefore, care immediately following hospitalization is an important part of addressing the crisis and working towards maintenance care. People who do not receive appropriate follow-up care are more likely to cease care and experience hospital readmissions, service and medication non-compliance, and self-injurious and dangerous behaviors. Because hospitalization may be particularly traumatic for autistic adults, appropriate follow-up care is vitally important. Very little is known about mental health care in autistic adults, including hospitalization for and follow-up care after mental health hospitalization. But the picture of limited provider availability, lack of provider knowledge, and siloed service systems suggest that care can be vastly improved. The purpose of this study is to examine the mental health hospitalizations of autistic adults and the care patterns following crisis compared to other adults hospitalized for mental health conditions. We will do this using two national sources of data: an all-payer hospital readmissions database and Medicaid claims. Using national all-payer hospitalization data allows a complete picture of experiences to inform improvement, while focusing on Medicaid claims allows a complete investigation of patterns and predictors of follow-up care service use and readmission. The ultimate goal is to inform service delivery system changes that increase care appropriateness and improve quality of life in autistic adults.

项目摘要自闭症成年人比同龄人同时出现心理健康问题的几率更高，从而影响生活质量并增加医疗保健的复杂性和成本。经历过逆境、孤立和耻辱可能会使自闭症患者面临更大的心理健康问题风险。心理健康服务可以发挥在支持人们应对心理健康问题方面发挥着关键作用。当心理健康状况不佳时解决后，问题经常升级到危机级别，可治疗的心理健康状况变得更加严重并随着时间的推移而禁用。虽然美国没有集中的精神健康危机系统，但紧急情况对于许多人来说，住院治疗是危机护理的一个组成部分。人们的了解还有限自闭症成人住院治疗，但初步结果表明存在心理健康问题，包括情绪障碍和精神分裂症是成人自闭症患者住院的最常见原因。虽然医院是心理健康紧急和危机护理的常见来源，但它们往往没有设备提供优质护理。由于医疗服务提供者缺乏相关知识，这个问题在自闭症患者中被放大。自闭症、多种并发疾病的高患病率以及使护理复杂化的自闭症特征包括感官敏感性以及新惯例和未知地点的困难。因此，应立即护理住院后是解决危机和努力维持护理的重要组成部分。没有接受适当后续护理的人更有可能停止护理并住院再次入院、服务和用药不合规、以及自残和危险行为。因为住院治疗对于成人自闭症患者来说可能会造成特别的创伤，适当的后续护理至关重要。人们对成人自闭症患者的心理健康保健知之甚少，包括住院治疗和后续护理精神健康住院后。但供应商可用性有限、缺乏供应商知识以及孤立的服务系统表明护理可以得到极大的改善。本研究的目的是检验与其他成年人相比，自闭症成人的心理健康住院情况以及危机后的护理模式因精神健康问题住院。我们将使用两个国家数据源来做到这一点：一家全付费医院再入院数据库和医疗补助索赔。使用全国所有付款人住院数据可以提供完整的提供改善信息的经验图片，同时关注医疗补助索赔，以便进行全面调查后续护理服务使用和再入院的模式和预测因素。最终目标是告知服务交付系统的改变可以提高护理的适当性并改善自闭症成人的生活质量。