Health Care Utilization by Persons With Severe and Persistent Mental Illness

“…Previous studies have associated mental illness with receiving fewer preventive services [46][47][48] and making fewer medical visits/stops. 46,48,49 Thus, at least for men with poorer mental functioning, it appears that VISN 13/23 successfully reduced some barriers to receiving primary care. Our response rate, although lower than ideal, was comparable to that of several other large veteran surveys.…”

Section: Discussionmentioning

confidence: 99%

Effect of Health-Related Quality of Life on Women and Men’s Veterans Affairs (VA) Health Care Utilization and Mortality

Singh

Murdoch

2007

J GEN INTERN MED

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INTRODUCTION:Although women will account for almost 11% of veterans by 2040, we know little about their health and functioning, particularly compared to men. OBJECTIVE:To compare women and men veterans' health-related quality of life (HRQOL) and VA health care utilization and to see if previously described associations between HRQOL, subsequent VA health care utilization, and mortality in male veterans would generalize to women veterans. METHODS:Prospective cohort study of all veterans who received medical care from an Upper Midwest Veterans Affairs facility between 10/1/96 and 3/31/98 and returned a mailed questionnaire.RESULTS: Women's effective survey response rate was 52% (n=1,500); men's, 58% (n=35,000). In the following year, 9% of women and 12% of men had at least one hospitalization. One percent of women and 3% of men died in the post-survey year. After adjustment, women's HRQOL was higher than men's; for every 10-point decrement in overall physical or mental functioning, women and men had similarly increased risk/odds of subsequently dying, being hospitalized at a VA facility, or making a VA outpatient stop. Among younger women and women who received VA care outside of the Twin City metro area, poorer overall mental or physical health functioning was associated with fewer primary care stops; among their male counterparts, it was associated with more primary care stops.CONCLUSION: Compared to men, women veterans receiving VA health care in the upper Midwest catchment area had better HRQOL and used fewer health services. Although VA health care utilization was similar across gender after adjusting for HRQOL, poorer mental or physical health was associated with fewer primary care stops for selected subgroups of women.

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“…10,11 Seriously mentally ill individuals had higher rates of outpatient care when compared with the general population. 12 Berren et al 13 found overall lower health care costs but a much higher use of emergency department and lower use of outpatient medical care among severely mentally ill patients who were publicly insured. Conversely, providing outpatient mental health services to people with mental health conditions may reduce their overall general medical expenses compared with their untreated peers 14,15 In one international study, comorbid medical conditions consistently increased health care costs and had greater influence on health care costs than depression alone.…”

mentioning

confidence: 99%

Mental Health Conditions are Associated With Increased Health Care Utilization Among Urban Family Medicine Patients

Fogarty¹,

Sharma²,

Chetty³

et al. 2008

The Journal of the American Board of Family Medicine

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Purpose: To assess the relationship between the presence of a mental health condition and health care utilization among family medicine patients.Methods: We used the Patient Health Questionnaire plus a posttraumatic stress disorder screen to measure 6 common mental health conditions. In a sample of 367 patients recruited from 3 urban family medicine practices affiliated with Boston University Medical Center, we measured self-reported health care utilization of primary care provider visits, emergency department visits, nonpsychiatric hospitalizations, and outpatient mental health visits. We determined the association between screening positive for the mental health conditions and health care utilization using both multivariable logistic regression and Poisson regression methods while controlling for sex, age, race, income, insurance status, marital status, educational level, and the presence of chronic medical conditions.Results: After controlling for potential confounders, generalized anxiety disorder, panic disorder, and posttraumatic stress disorder were statistically significantly associated with more PCP visits, ED visits, and nonpsychiatric hospitalizations. Neither major nor minor depression were associated with more PCP visits, ED visits, or nonpsychiatric hospitalizations, except that minor depression was associated with 103% increase in PCP visits (P < .001). Alcohol use disorder was associated with 16% fewer PCP visits (P ‫؍‬ .01) but 238% more nonpsychiatric hospitalizations (P < .001).Conclusions : Mental health conditions are common among adult primary care patients and contribute to lower functional status and increased health care utilization.

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Health Care Utilization by Persons With Severe and Persistent Mental Illness

Cited by 69 publications

References 9 publications

Care by general practitioners and district nurses of patients receiving home nursing: a study from suburban Stockholm

Care by general practitioners and district nurses of patients receiving home nursing: a study from suburban Stockholm

Effect of Health-Related Quality of Life on Women and Men’s Veterans Affairs (VA) Health Care Utilization and Mortality

Mental Health Conditions are Associated With Increased Health Care Utilization Among Urban Family Medicine Patients

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