A systematic review of the predictors of health service utilisation by adults with mental disorders in the UK.
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Authors
Twomey, Conal D
Baldwin, David S
Hopfe, Maren
Cieza, Alarcos
Issue Date
2015-07-06
Type
Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review
Research Support, Non-U.S. Gov't
Review
Systematic Review
Language
en
Keywords
HEALTH ECONOMICS , HEALTH SERVICES ADMINISTRATION & MANAGEMENT , MENTAL HEALTH
Alternative Title
Abstract
To identify variables that predict health service utilisation (HSU) by adults with mental disorders in the UK, and to determine the evidence level for these predictors.
A narrative synthesis of peer-reviewed studies published after the year 2000. The search was conducted using four databases (ie, PsycINFO, CINAHL Plus with full text, MEDLINE and EMBASE) and completed on 25 March 2014.
The majority of included studies were set in health services across primary, secondary, specialist and inpatient care. Some studies used data from household and postal surveys.
Included were UK-based studies that predicted HSU by adults with mental disorders. Participants had a range of mental disorders including psychotic disorders, personality disorders, depression, anxiety disorders, eating disorders and dementia.
A wide range of HSU outcomes were examined, including general practitioner (GP) contacts, medication usage, psychiatrist contacts, psychotherapy attendances, inpatient days, accident and emergency admissions and 'total HSU'.
Taking into account study quality, 28 studies identified a range of variables with good preliminary evidence supporting their ability to predict HSU. Of these variables, comorbidity, personality disorder, age (heterogeneous age ranges), neurotic symptoms, female gender, a marital status of divorced, separated or widowed, non-white ethnicity, high previous HSU and activities of daily living, were associated with increased HSU. Moreover, good preliminary evidence was found for associations of accessing a primary care psychological treatment service and medication use with decreased HSU.
The findings can inform decisions about which variables might be used to derive mental health clusters in 'payment by results' systems in the UK. The findings also support the need to investigate whether combining broad diagnoses with care pathways is an effective method for mental health clustering, and the need for research to further examine the association between mental health clusters and HSU.
A narrative synthesis of peer-reviewed studies published after the year 2000. The search was conducted using four databases (ie, PsycINFO, CINAHL Plus with full text, MEDLINE and EMBASE) and completed on 25 March 2014.
The majority of included studies were set in health services across primary, secondary, specialist and inpatient care. Some studies used data from household and postal surveys.
Included were UK-based studies that predicted HSU by adults with mental disorders. Participants had a range of mental disorders including psychotic disorders, personality disorders, depression, anxiety disorders, eating disorders and dementia.
A wide range of HSU outcomes were examined, including general practitioner (GP) contacts, medication usage, psychiatrist contacts, psychotherapy attendances, inpatient days, accident and emergency admissions and 'total HSU'.
Taking into account study quality, 28 studies identified a range of variables with good preliminary evidence supporting their ability to predict HSU. Of these variables, comorbidity, personality disorder, age (heterogeneous age ranges), neurotic symptoms, female gender, a marital status of divorced, separated or widowed, non-white ethnicity, high previous HSU and activities of daily living, were associated with increased HSU. Moreover, good preliminary evidence was found for associations of accessing a primary care psychological treatment service and medication use with decreased HSU.
The findings can inform decisions about which variables might be used to derive mental health clusters in 'payment by results' systems in the UK. The findings also support the need to investigate whether combining broad diagnoses with care pathways is an effective method for mental health clustering, and the need for research to further examine the association between mental health clusters and HSU.
Description
Citation
Twomey, C. D., Baldwin, D. S., Hopfe, M., & Cieza, A. (2015). A systematic review of the predictors of health service utilisation by adults with mental disorders in the UK. BMJ open, 5(7), e007575. https://doi.org/10.1136/bmjopen-2015-007575
Publisher
License
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Journal
BMJ open
Volume
5
Issue
7
PubMed ID
DOI
10.1136/bmjopen-2015-007575
10.1108/14777260910966735
10.1007/s10729-006-9039-7
10.2471/BLT.12.115931
10.1192/bjp.bp.110.090993
10.1192/bjp.200.2.163
10.1080/09638239619121
10.1176/ajp.143.2.131
10.1056/NEJM198611203152106
10.1192/bjp.200.2.162
10.1192/pb.bp.112.041780
10.1016/j.jclinepi.2007.11.008
10.1176/ps.46.12.1247
10.1111/j.1600-0447.1992.tb03263.x
10.1186/1472-6963-14-161
10.1007/s10597-011-9439-0
10.1176/ps.2007.58.1.63
10.1007/s00127-012-0576-8
10.1192/bjp.181.5.428
10.3109/09638237.2011.562261
10.1136/bmjopen-2013-004606
10.1192/pb.29.4.134
10.2165/11537360-000000000-00000
10.1016/j.jval.2013.09.001
10.1017/S0033291708004911
10.1192/bjp.188.5.423
10.1016/j.jad.2010.04.020
10.1007/s00127-012-0565-y
10.1080/0954026021000045985
10.3399/bjgp10X501822
10.1093/eurpub/ckl248
10.1007/s00127-006-0094-7
10.1093/schbul/sbl013
10.1176/ps.2007.58.7.977
10.1002/pmh.70
10.1192/bjp.bp.110.085092
10.1007/s001270050242
10.1111/j.1752-0118.2012.01286.x
10.1002/gps.543
10.1176/appi.ajp.2007.07040636
10.1007/s00127-005-0989-8
10.1136/jech.2011.139873
10.1016/j.brat.2013.03.004
10.1177/026988110201600208
10.1192/bjp.186.6.500
10.3111/13696998.2012.672941
10.1185/03007991003738519
10.3310/hta16480
10.1108/14777260910966735
10.1007/s10729-006-9039-7
10.2471/BLT.12.115931
10.1192/bjp.bp.110.090993
10.1192/bjp.200.2.163
10.1080/09638239619121
10.1176/ajp.143.2.131
10.1056/NEJM198611203152106
10.1192/bjp.200.2.162
10.1192/pb.bp.112.041780
10.1016/j.jclinepi.2007.11.008
10.1176/ps.46.12.1247
10.1111/j.1600-0447.1992.tb03263.x
10.1186/1472-6963-14-161
10.1007/s10597-011-9439-0
10.1176/ps.2007.58.1.63
10.1007/s00127-012-0576-8
10.1192/bjp.181.5.428
10.3109/09638237.2011.562261
10.1136/bmjopen-2013-004606
10.1192/pb.29.4.134
10.2165/11537360-000000000-00000
10.1016/j.jval.2013.09.001
10.1017/S0033291708004911
10.1192/bjp.188.5.423
10.1016/j.jad.2010.04.020
10.1007/s00127-012-0565-y
10.1080/0954026021000045985
10.3399/bjgp10X501822
10.1093/eurpub/ckl248
10.1007/s00127-006-0094-7
10.1093/schbul/sbl013
10.1176/ps.2007.58.7.977
10.1002/pmh.70
10.1192/bjp.bp.110.085092
10.1007/s001270050242
10.1111/j.1752-0118.2012.01286.x
10.1002/gps.543
10.1176/appi.ajp.2007.07040636
10.1007/s00127-005-0989-8
10.1136/jech.2011.139873
10.1016/j.brat.2013.03.004
10.1177/026988110201600208
10.1192/bjp.186.6.500
10.3111/13696998.2012.672941
10.1185/03007991003738519
10.3310/hta16480
ISSN
2044-6055