Mental health care provision in community health centers and hospital emergency department utilization
研究2012-2019年佛罗里达州数据，发现社区卫生中心精神卫生服务增加与急诊科精神卫生就诊小幅减少相关，提示社区服务可部分替代急诊。
OBJECTIVES: To examine whether community health centers (CHCs) are effective in offsetting mental health emergency department (ED) visits. DATA SOURCES AND STUDY SETTING: The HRSA Uniform Data System and the HCUP State ED Databases for Florida patients during 2012-2019. STUDY DESIGN: We identified CHC-year-specific service areas using patient origin zip codes. We then estimated panel data models for number of ED mental health visits per capita in a CHC's service area. Models measured CHC mental health utilization as number of visits, unique patients, and intensity (visits per patient). PRINCIPAL FINDINGS: CHC mental health utilization increased approximately 100% during 2012-2019. Increased CHC mental health provision was associated with small reductions in ED mental health utilization. An annual increase of 1000 CHC mental health care visits (5%) was associated with 0.44% fewer ED mental health care visits (p = 0.153), and an increase of 1000 CHC mental health care patients (15%) with 1.9% fewer ED mental health care visits (p = 0.123). An increase of 1 annual mental health visit per patient was associated with 16% fewer ED mental health care visits (p = 0.011). CONCLUSIONS: Results suggest that mental health provision in CHCs may reduce reliance on hospital EDs, albeit minimally. Policies that promote alignment of services between CHCs and local hospitals may accelerate this effect.