Predictors of emergency department and GP use among patients with mental health conditions: a public health survey.
Adult
Emergency Service, Hospital
/ statistics & numerical data
England
/ epidemiology
Female
General Practice
/ statistics & numerical data
Health Services Needs and Demand
Health Services Research
Health Surveys
Humans
Male
Mental Disorders
/ epidemiology
Middle Aged
Patient Acceptance of Health Care
/ statistics & numerical data
Public Health
Social Determinants of Health
/ statistics & numerical data
Socioeconomic Factors
Young Adult
emergency departments
mental health
primary care
service use
social care
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
01
04
2019
accepted:
16
07
2019
pubmed:
19
12
2019
medline:
8
7
2020
entrez:
19
12
2019
Statut:
epublish
Résumé
High demand for health services is an issue of current importance in England, in part because of the rapidly increasing use of emergency departments (EDs) and GP practices for mental health conditions and the high cost of these services. To examine the social determinants of health service use in people with mental health issues. Twenty-eight neighbourhoods, each with a population of 5000-10 000 people, in the north west coast of England with differing levels of deprivation. A comprehensive public health survey was conducted, comprising questions on housing, physical health, mental health, lifestyle, social issues, environment, work, and finances. Poisson regression models assessed the effect of mental health comorbidity, mental and physical health comorbidity, and individual mental health symptoms on ED and general practice attendances, adjusting for relevant socioeconomic and lifestyle factors. Participants who had both a physical and mental health condition reported attending the ED (rate ratio [RR] = 4.63, 95% confidence interval [CI] = 2.86 to 7.51) and general practice (RR = 3.82, 95% CI = 3.16 to 4.62) more frequently than all other groups. Having a higher number of mental health condition symptoms was associated with higher general practice and ED service use. Depression was the only mental health condition symptom that was significantly associated with ED attendance (RR = 1.41, 95% CI = 1.05 to 1.90), and anxiety was the only symptom significantly associated with GP attendance (RR = 1.19, 95% CI = 1.03 to 1.38). Mental health comorbidities increase the risk of attendances to both EDs and general practice. Further research into the social attributes that contribute to reduced ED and general practice attendance rates is needed.
Sections du résumé
BACKGROUND
BACKGROUND
High demand for health services is an issue of current importance in England, in part because of the rapidly increasing use of emergency departments (EDs) and GP practices for mental health conditions and the high cost of these services.
AIM
OBJECTIVE
To examine the social determinants of health service use in people with mental health issues.
DESIGN AND SETTING
METHODS
Twenty-eight neighbourhoods, each with a population of 5000-10 000 people, in the north west coast of England with differing levels of deprivation.
METHOD
METHODS
A comprehensive public health survey was conducted, comprising questions on housing, physical health, mental health, lifestyle, social issues, environment, work, and finances. Poisson regression models assessed the effect of mental health comorbidity, mental and physical health comorbidity, and individual mental health symptoms on ED and general practice attendances, adjusting for relevant socioeconomic and lifestyle factors.
RESULTS
RESULTS
Participants who had both a physical and mental health condition reported attending the ED (rate ratio [RR] = 4.63, 95% confidence interval [CI] = 2.86 to 7.51) and general practice (RR = 3.82, 95% CI = 3.16 to 4.62) more frequently than all other groups. Having a higher number of mental health condition symptoms was associated with higher general practice and ED service use. Depression was the only mental health condition symptom that was significantly associated with ED attendance (RR = 1.41, 95% CI = 1.05 to 1.90), and anxiety was the only symptom significantly associated with GP attendance (RR = 1.19, 95% CI = 1.03 to 1.38).
CONCLUSION
CONCLUSIONS
Mental health comorbidities increase the risk of attendances to both EDs and general practice. Further research into the social attributes that contribute to reduced ED and general practice attendance rates is needed.
Identifiants
pubmed: 31848197
pii: bjgp19X707093
doi: 10.3399/bjgp19X707093
pmc: PMC6917360
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1-e8Informations de copyright
©The Authors.
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