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1
A New Acute-At-Home Child and Adolescent Clinical Service: Evaluation of Impact

Noorani Khalfan,Carol Coventry,David Cawthorpe 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.1
- 원문보기 2
  KCI
  
  스콜라
Objective An Acute at Home (AAH) clinical service was implemented to reduce emergency and inpatient admissions to the regional tertiary child and adolescent mental health system. This paper examines describes the served the population and impact on emergency and inpatient admissions. Methods Analysis of re-admission rates for those enrolled before and after the May 2019 implementation of the AAH service in comparison over the same time period to an unexposed comparison group. In addition the groups were compared on clinical and demographic variables comparing those exposed and those not exposed to the AAH service. Results The results indicated that the AAH group experienced reduced rates of readmission and lengths of stay post-exposure. Family composition, sex, seven Adverse Childhood Experience survey items, and nine Western Canada Waitlist Child Mental Health Priority Criteria Score items distinguished those exposed to AAH compared to those who were not. Thirteen of 19 independent variables indicated greater pathology in the AAH group with less likelihood of potential of danger to self. Conclusion The present results indicate a substantial benefit of the AAH service via reducing readmissions and lengths of stay. The quantitative measures warrant a careful qualitative examination of the AAH processes along with ongoing monitoring of the program’s effect.
2
The Temporal Hyper-Morbidity of Asthma and Attention Deficit Disorder: Implications for Interpretation Based on Comparison of Prospective and Cross-Sectional Population Samples

Pang Hua Chai,Sam Chang,David Cawthorpe 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.2
- 원문보기 2
  KCI
  
  스콜라
Objective The purpose of this study was to test the hypothesis that a significant temporal relationship exists between asthma and attention deficit hyperactivity disorder (ADHD). Methods The population dataset consisted of 95,846,511 physician diagnoses for 768,460 (46% male) individuals spanning 1993-2010. Four groups were labeled as having neither Asthma nor ADHD, Asthma only, ADHD only, or both Asthma and ADHD and formed the basis of calculating the odds ratios for each sex describing the association of Asthma and ADHD by age, and, in addition, a prospective sample age (<5 years) between 1993 and 1996 was utilized to evaluate the temporal association between Asthma and ADHD. Results There was a significant relationship between ADHD and Asthma within the age strata of the sample, one from the cohort and two from the whole sample. When both ADHD and Asthma were diagnosed in the same patients, the age was younger in both cross-sectional and prospective cohort samples. ADHD arose significantly more often after Asthma in the cross-sectional samples stratified on age and in the prospective cohort sample. Conclusion The results are consistent with previous literature where ADHD has been linked to allergic diseases, such as asthma.
3
The Economic Impact of Providing Evidence-Based Pediatric Mental Health Literacy Training to Primary Care Physicians

Eden McCaffrey,Samuel Chang,Geraldine Farrelly,Abdul Rahman,Blair Ritchie,Roxanne Goldade,David Cawthorpe 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.7
- 원문보기 2
  KCI
  
  스콜라
Objective This paper presents a review of the current state of child and adolescent mental health literacy and provides current evidence of the economic impact of a pediatric mental health literacy (MHL) training program. Methods Employing a case-series-comparison design, physician referrals to urgent and specialized mental health services were linked with patient-specific information comparing referrals from MHL participants and non-participating physicians. The economic impact analysis was based on changes in the admitted referral frequency and lengths of stay for the MHL group, compared to themselves pretraining, and over the same time period compared to non-participating physicians. Results Average scheduled ambulatory admission rates per physician remained constant for trained and untrained pre-post groups. Average scheduled ambulatory admission wait time and length of stay reduced significantly post-training for MHL-trained physicians compared to pre-training and untrained physicians. In addition to reductions in length of stay, the total bed costs saving for emergency/inpatients admission deferrals was $2,932,112 or about $20,000 per MHL-trained physician. Conclusion The estimated economic impact of the MHL training shows a substantial return on investment and supports wider implementation. The MHL training program should be a key feature of mental health reform strategies, as well as continuing and undergraduate medical education.