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Patterns of mental health care utilisation: distribution of services and its predictability from routine data

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objectives

Explore if a multi-dimensional analytic approach to routinely registered data provides a comprehensive way to characterise utilisation patterns, and to test if the patients’ functional status is a predictor for the use of services.

Method

We linked register contact data during a two-year period, including all types of specialised mental health services, in the population of a Norwegian county. Cox regression was applied in the models for prediction of admission and readmission.

Results

Great variability and complexity in patterns of utilisation were found, including multiple transitions between in-patient and out-patient statuses. The distribution of services was characterised by a small group of patients receiving a disproportionally large amount of resources. A majority of 77% appeared as out-patients only. Severity of symptoms as well as of dysfunction, as assessed by the split GAF-score, differentiated amongst utilisation groups. Both dimensions were significant predictors for admission. In contrast, only the severity of dysfunction predicted readmission.

Conclusion

Multi-dimensional data architecture and analytical perspectives can be applied to routine data, and should be used to analyse the diverse patterns of utilisation. Risk populations could be predicted by routinely registered information on functional status.

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Acknowledgments

The study was partly supported by the Samdata-project at Sintef Health Research Trondheim Norway, where all three authors were employed at the start of the study period. The Samdata-project was financed by the Norwegian Ministry of Health and Care Services. We also acknowledge the assistance of the Norwegian Patient Register, and those responsible for the mental health informatics in the county of Vestfold.

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Author notes

  1. Solfrid E. Lilleeng

    Present address: Health Economy and Financing Division, Norwegian Directorate of Health, Trondheim, Norway

Authors and Affiliations

  1. Performance Data Unit, Department of Research and Development, Haukeland University Hospital, 5021, Bergen, Norway

    Torhild Heggestad

  2. Sintef Health Research, Trondheim, Norway

    Solfrid E. Lilleeng

  3. Division of Mental Health Services, Department of Research and Development, Akershus University Hospital, Lørenskog, Norway

    Torleif Ruud

  4. Institute of Psychiatry, University of Oslo, Oslo, Norway

    Torleif Ruud

Authors
  1. Torhild Heggestad
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  2. Solfrid E. Lilleeng
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  3. Torleif Ruud
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Correspondence to Torhild Heggestad.

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Heggestad, T., Lilleeng, S.E. & Ruud, T. Patterns of mental health care utilisation: distribution of services and its predictability from routine data. Soc Psychiatry Psychiatr Epidemiol 46, 1275–1282 (2011). https://doi.org/10.1007/s00127-010-0295-y

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