Use of mental health services in south Verona and Groningen

Abstract

A comparison was made of the utilization of mental health services in a psychiatric case register area in Italy (south Verona) and one in the Netherlands (Groningen). All residents living in these areas who contacted a mental health service in 1982 were traced and followed for a period of one year. The year prevalence rates differed considerably (110/10,000 in south Verona and 329/10,000 in Groningen). Rates of single consulters were similar in both areas, while those of chronic inpatients were more than 11 times higher in Groningen than in south Verona. After excluding both single consulters and chronic inpatients, when comparing service consumption according to fixed classes of scores, the category of highest service use accounted for 60% of care provided in Groningen as compared with less than 30% in south Verona. The proportion of total service consumption due to inpatient care was about the same in both areas, but brief admissions were more common in south Verona. Moreover, when service use was considered as a relative construct, about 10% of patients in both areas could be called high users. Finally, long-term patients were more prevalent in Groningen (26%) than in south Verona (13%).

Consumption of Mental Health Services by People with Intellectual Disabilities

“…In a review of studies on the patterns of care in generic mental health services Hansson & Sandlund (1992) found that a small proportion of service users use a large proportion of resources. Lavik (1983) found an 'inequality' of service use, with 10% of service users using 75% of service resources, and Sytema et al (1989) found that 8% of service users were using 60% of the services. This review also highlighted a number of factors that could be used to predict heavier service use, such as living alone or having no occupation.…”

Long-term care. A cohort study using the Portoguaro Case Register

“…Lo studio dei pattern di utilizzazione dei servizi psichiatrici da parte dei pazienti residenti in un territorio definito e stato oggetto di indagini approfondite negli ultimi anni (Tansella, 1987;Tansella et al, 1994;Sytema et al, 1989a;Balestrieri et al, 1987;1989;Viscogliosi-Calabrese et al, 1990). I patterns di utilizzazione sono stati descritti utilizzando indici epidemiologici di tipo temporale, di tipo quantitativo e di tipo combinato.…”

“…Nel lavoro originario di Lavik (1983) -che ha introdotto questo tipo di misura -il punteggio-soglia era determinato in modo arbitrario e corrispondeva a 200 punti in due anni; in altri lavori il punteggio-soglia e stato calcolato con l'analisi della varianza, cosi che tale punteggio -non piii scelto arbitrariamente -risultava dipendente dalle caratteristiche della coorte esaminata (Tansella etal., 1986;Sytema et al, 1989a). Se nel caso dei lungoassistiti vi e, allo stato attuale delle cose, pressocche completo accordo nella letteratura sui criteri di definizione, per cio che riguarda gli alti utilizzatori, ferma restando la attribuzione di determinati punteggi ai diversi tipi di contatto (ricovero, day-hospital, territorio), sono stati adottati due criteri diversi per individuare il punteggio soglia per definire gli alti utilizzatori.…”

Outcome measures in mental health service research

“…It developed during the dawn of the deinstitutionalization era in the 1960s and has been rapidly expanding during the last decade. Outcome measures have been predominantly used to evaluate the effects of major changes in the health care system (Wing, 1972;Nielsen et al, 1981;Hafner et al, 1980;Tansella et al, 1991) and to compare the outcomes of different mental health care systems (Sytema, 1994;Sytema et al, 1989) and programs (Test et al, 1978). Unfortunately, the results of mental health service research have rarely made a major impact on the political arid administrative level of planning and development of mental health services.…”