Access to a regular primary care physician among young people with early psychosis in Ontario, Canada.

Autor: Rodrigues R; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada., Reid JNS; ICES, Toronto, Ontario, Canada., Wiener JC; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada., Archie S; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada., Booth RG; Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada., Cheng C; Department of Psychiatry, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada., MacDougall AG; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada., Palaniyappan L; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.; Centre for Youth Mental Health, Douglas Mental Health University Institute, Montreal, Quebec, Canada., Ryan BL; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.; Centre for Studies in Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.; Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada., Voineskos A; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada., Kurdyak P; ICES, Toronto, Ontario, Canada.; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada., Jan SH; Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada., Anderson KK; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.; ICES, Toronto, Ontario, Canada.; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Jazyk: angličtina
Zdroj: Early intervention in psychiatry [Early Interv Psychiatry] 2024 Jul; Vol. 18 (7), pp. 513-523. Date of Electronic Publication: 2023 Nov 30.
DOI: 10.1111/eip.13487
Abstrakt: Aim: Access to a primary care physician in early psychosis facilitates help-seeking and engagement with psychiatric treatment. We examined access to a regular primary care physician in people with early psychosis, compared to the general population, and explored factors associated with access.
Methods: Using linked health administrative data from Ontario (Canada), we identified people aged 14-35 years with a first diagnosis of nonaffective psychotic disorder (n = 39 449; 2005-2015). We matched cases to four randomly selected general population controls based on age, sex, neighbourhood, and index date (n = 157 796). We used modified Poisson regression to estimate prevalence ratios (PR) for access to a regular primary care physician in the year prior to first diagnosis of psychotic disorder, and the sociodemographic and clinical factors associated with access.
Results: A larger proportion of people with early psychosis had a regular primary care physician, relative to the general population (89% vs. 68%; PR = 1.30, 95%CI = 1.30-1.31). However, this was accounted for by a higher prevalence of comorbidities among people with psychosis, and this association was no longer present after adjustment (PR = 0.97, 95%CI = 0.97, 0.98). People with early psychosis who were older, male, refugees and those residing in lower income or high residential instability neighbourhoods were less likely to have a regular primary care physician.
Conclusion: Approximately one in ten young people with early psychosis in Ontario lack access to a regular primary care physician. Strategies to improve primary care physician access are needed for management of physical comorbidities and to ensure continuity of care.
(© 2023 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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