Factors Associated with the Use of Primary Care Centres in Persons with Schizophrenia

Abstract

Background. Patients with schizophrenia and related disorders have more physical problems than the general population. Primary care professionals play an important role in the care of these patients as they are the main entry point into the healthcare system. We aimed to identify patient, general practitioner, and primary care centre factors associated with the number of visits of patients with schizophrenia and related disorders to general practitioners. Methods. A descriptive, cross-sectional study was conducted in 13 primary care centres belonging to the Clinical Management Unit of Mental Health of the Regional Hospital of Málaga, Spain. The eligible population was composed of patients with schizophrenia and related disorders attending these primary care centres in the study area. Our dependent variable was the total number of general practitioner visits made by patients with schizophrenia and related disorders during the 3.5-year observation period. The independent variables were grouped into three: a) patient variables (sociodemographic and clinical), b) general practitioner variables, and c) primary care centre characteristics. Descriptive, bivariate, and multivariate analyses using the random forest method were performed. Results. A total of 259 patients with schizophrenia and related disorders, 96 general practitioners, and 13 primary care centres were included. The annual mean was 3.9 visits per patient. The results showed that general practitioner age, patient gender, patient marital status, primary care centre to which the patient belonged, taking antipsychotic medication, presenting any cardiovascular risk factor, and frequency of mental health training sessions at the primary care centre were associated with an increased number of visits to general practitioners. Conclusions. The only general practitioner characteristic that was associated with the number of visits was age. There were also patient variables involved in the number of visits. Finally, mental health training for general practitioners was important for these professionals to manage patients with schizophrenia and related disorders.