Poor longitudinal continuity of care is associated with an increased mortality rate among patients with mental disorders: Results from the French National Health Insurance Reimbursement Database

Hoertel, Nicolas; Limosin, Frédéric; Leleu, Henri

doi:10.1016/j.eurpsy.2013.12.001

Cited by 73 publications

(55 citation statements)

References 50 publications

(70 reference statements)

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“…Individuals seeking treatment for MDE tend to have relatively high rates of comorbidity and depression severity (Blumenthal and Endicott, 1996; Cohen and Cohen, 1984; Hoertel et al, 2013d, 2014; Kendler, 1995). In our study, only half of the participants who had a persistent or a recurrent MDE sought help for depression at Wave 1.…”

Section: Discussionmentioning

confidence: 99%

A comprehensive model of predictors of persistence and recurrence in adults with major depression: Results from a national 3-year prospective study

Hoertel

Blanco

Oquendo

et al. 2017

Journal of Psychiatric Research

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Identifying predictors of persistence and recurrence of depression in individuals with a major depressive episode (MDE) poses a critical challenge for clinicians and researchers. We develop using a nationally representative sample, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N=34,653), a comprehensive model of the 3-year risk of persistence and recurrence in individuals with MDE at baseline. We used structural equation modeling to examine simultaneously the effects of four broad groups of clinical factors on the risk of MDE persistence and recurrence: 1) severity of depressive illness, 2) severity of mental and physical comorbidity, 3) sociodemographic characteristics and 4) treatment-seeking behavior. Approximately 16% and 21% of the 2,587 participants with an MDE at baseline had a persistent MDE and a new MDE during the 3-year follow-up period, respectively. Most independent predictors were common for both persistence and recurrence and included markers for the severity of the depressive illness at baseline (as measured by higher levels on the general depressive symptom dimension, lower mental component summary scores, prior suicide attempts, younger age at onset of depression and greater number of MDEs), the severity of comorbidities (as measured by higher levels on dimensions of psychopathology and lower physical component summary scores) and a failure to seek treatment for MDE at baseline. This population-based model highlights strategies that may improve the course of MDE, including the need to develop interventions that target multiple psychiatric disorders and promotion of treatment seeking to increase access to timely mental health care.

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Section: Discussionmentioning

confidence: 99%

A comprehensive model of predictors of persistence and recurrence in adults with major depression: Results from a national 3-year prospective study

Hoertel

Blanco

Oquendo

et al. 2017

Journal of Psychiatric Research

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“…Most of the previous studies used claims data from health insurance reimbursement databases [3–6, 11, 42]. Moreover, the outcomes of these studies focused on health resource utilization (hospitalizations and emergency department visits) and healthcare expenses.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of continuity of care have been debated in previous studies because some have concluded that continuity of care is associated with fewer hospitalizations, emergency department visits, and hospital admissions [3–7]; low pharmaceutical expenditures and healthcare expenses [5, 8–10]; decreased mortality rates [11, 12]; fewer duplicated medications [13]; improved medication adherence [14]; and patient satisfaction [15–18]. However, others insist that high continuity of care may lead to the purchase of more drugs overall and that the effects on HRQoL are unclear; thus, these should be further examined [19, 20].…”

Section: Introductionmentioning

confidence: 99%

Effect of continuity of care on health-related quality of life in adult patients with hypertension: a cohort study in China

Sun

Tang

et al. 2016

BMC Health Serv Res

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BackgroundContinuity of care is widely considered a principle of primary care that decreases healthcare utilization and mortality. However, the effect of continuity of care on health-related quality of life (HRQoL) for adult patients with hypertension remains unclear.MethodsTo further evaluate the effect of continuity of care, we implemented a cohort study among hypertensive patients aged over 35 years (n = 1200) in six townships in Qianjiang District, Chongqing, China, between 2012 and 2014. The study ultimately included 1079 participants. The continuity of care index was calculated using claim-based longitudinal data obtained from hypertension follow-up service records. The baseline and endline survey-based data, tested by the SF-36 scale, were used to assess HRQoL. To control selection bias and examine the effect of continuity of care, a kernel-based propensity score matching difference-in-differences (DID) method was used. Additionally, descriptive statistics, chi-squared test, and Mann–Whitney nonparametric test were used to summarize characteristics, evaluate proportional differences, and analyze statistical differences, respectively.ResultsOur results showed that patients in the high continuity of care group presented greater improvement in both Physical Component Summary (PCS, DID = 5.192 ± 1.970, p < 0.001) and Mental Component Summary (MCS, DID = 7.900 ± 1.815, p = 0.008) than those in the low continuity of care group. Moreover, patients in the high continuity of care group showed significant improvement in physical functioning, role-physical, general health, role-emotional, and mental health.ConclusionsOur findings indicate that a long-term physician-patient relationship may improve HRQoL in patients with hypertension. However, more unified measurement tools are needed to evaluate continuity of care. Further studies should include more study settings.

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“…Healthier lifestyles (including the absence of alcohol, nicotine and illicit drug consumption) and better protection from some social risks in older adults (Blazer and Hybels, 2005), cohort effects on sociodemographic and environmental characteristics (e.g., differential rate in exposure to stressful life events or use of drugs) (Keyes et al, 2011; Simon et al, 1995), premature mortality among individuals with mental disorders and period effects (Beekman et al, 1999; Bruce and Leaf, 1989; Hoertel et al, 2014; Kessler et al, 2010; Lemogne et al, 2013; Tsuang and Simpson, 1985) may also contribute to explain lower propensity to psychopathology among older adults. These findings suggest that prevention efforts that focus on age-related core psychological processes (such as neuroticism levels) are likely to be effective in multiple disorders.…”

Section: Discussionmentioning

confidence: 99%

A dimensional liability model of age differences in mental disorder prevalence: Evidence from a national sample

Hoertel

McMahon

Olfson

et al. 2015

Journal of Psychiatric Research

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Recent theories have proposed a metastructure that organizes related mental disorders into broad dimensions of psychopathology (i.e., internalizing and externalizing dimensions). Prevalence rates of most mental disorders, when examined independently, are substantially lower in older than in younger adults, which may affect this metastructure. Within a nationally representative sample, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093), we developed a dimensional liability model of common psychiatric disorders to clarify whether aging affects specific disorders or general dimensions of psychopathology. Significant age differences existed across age groups (18-24, 25-34, 35-44, 45-54, 55-64, 65-75 and 75+), such that older adults showed lower prevalence rates of most disorders compared to younger adults. We next investigated patterns of disorder comorbidity for past-year psychiatric disorders and found that a distress-fear-externalizing liability model fit the data well. This model was age-group invariant and indicated that that the observed lower prevalence of mental disorders with advancing age originates from lower average means on externalizing and internalizing liability dimensions. This unifying dimensional liability model of age and mental disorder comorbidity can help inform the role of aging on mental disorder prevalence for research and intervention efforts, and service planning for the impending crisis in geriatric mental health.

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Poor longitudinal continuity of care is associated with an increased mortality rate among patients with mental disorders: Results from the French National Health Insurance Reimbursement Database

Abstract: Improving longitudinal continuity of care in mental health care may contribute to substantially decrease mortality.

Cited by 73 publications

References 50 publications

A comprehensive model of predictors of persistence and recurrence in adults with major depression: Results from a national 3-year prospective study

A comprehensive model of predictors of persistence and recurrence in adults with major depression: Results from a national 3-year prospective study

Effect of continuity of care on health-related quality of life in adult patients with hypertension: a cohort study in China

A dimensional liability model of age differences in mental disorder prevalence: Evidence from a national sample

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