Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis

Autor: Fermín Mayoral, Antoni Serrano-Blanco, Berta Moreno-Küstner, José María García-Herrera, Juan Ángel Bellón, Pedro Angona, Desiree Navas, Javier Requena, Patricia Moreno, Fabio Rivas
Přispěvatelé: Research network 'redIAPP', 'SAMSERAP' group, [Moreno-Küstner,B] Research Unit Distrito Sanitario Malaga, IMABIS Fundation. Department of Personality, Evaluation and Psychological Treatment, University of Malaga,Spain. (Research network 'redIAPP', 'SAMSERAP' group. [Mayora,F] Psychiatric Service, University Hospital Carlos Haya, Malaga, Spain, (Research network 'redIAPP','SAMSERAP' group. [Rivas,F] Psychiatric Service, University Hospital Carlos Haya, Malaga, Spain. [Angona,P] Community Mental Health Centre 'Guadalmedina'. University Hospital Carlos Haya, Malaga, Spain (Research network 'redIAPP','SAMSERAP' group. [Requena,J, García-Herrera,JM] Community Mental Health Centre 'Centro'. University Hospital Carlos Haya, Malaga, Spain, (Research network 'redIAPP','SAMSERAP' group. [Navas,D, Moeno,P] Research Unit Distrito Sanitario Malaga, IMABIS Foundation, Malaga, Spain, (Research network 'redIAPP', 'SAMSERAP' group. [Serrano-Blanco,A] Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain, (Research network 'redIAPP', 'SM-SJ de Déu' group. [Bellón,JA] Health Centre El Palo. Research Unit Distrito Sanitario Málaga (Research network 'redIAPP', 'SAMSERAP' group). Department of Preventive Medicine, University of Malaga, Spain., This study was supported by the Andalusian Government (grant references: 05/353, PI-0338/08, PI-0332/08, P10-CTS-5862, CTS-587) and the Spanish Ministry of Health (RedIAPP: RD06/0018/0039).
Rok vydání: 2011
Předmět:
Male
Cross-sectional study
España
Health Care::Population Characteristics::Socioeconomic Factors [Medical Subject Headings]
Esquizofrenia
Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings]
Severity of Illness Index
Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]
Risk Factors
Ambulatory Care
Medicine
Health Care::Health Care Quality
Access
and Evaluation::Delivery of Health Care::Attitude to Health::Patient Acceptance of Health Care [Medical Subject Headings]
Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings]
Modelo lineales
Delusional disorder
Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Statistics as Topic::Multilevel Analysis [Medical Subject Headings]
lcsh:Public aspects of medicine
Health Policy
Health services research
Factores Socioeconómicos
Middle Aged
Community Mental Health Services
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies [Medical Subject Headings]
Health Care::Health Care Quality
Access
and Evaluation::Quality of Health Care::Epidemiologic Factors::Causality::Risk Factors [Medical Subject Headings]
Schizophrenia
Servicios Comunitarios de Salud Mental
Multilevel Analysis
Female
Health Services Research
Health Care::Health Care Quality
Access
and Evaluation::Health Services Research [Medical Subject Headings]
Factores de riesgo
Research Article
Adult
medicine.medical_specialty
Check Tags::Male [Medical Subject Headings]
Ambulatory care
Severity of illness
Psychiatry and Psychology::Mental Disorders::Schizophrenia and Disorders with Psychotic Features::Schizophrenia [Medical Subject Headings]
Named Groups::Persons::Age Groups::Adult [Medical Subject Headings]
Humans
Aceptación de la Atención de Salud
Psychiatry
Análisis de niveles múltiples
Health Care::Health Care Facilities
Manpower
and Services::Health Services::Community Health Services [Medical Subject Headings]
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Regression Analysis [Medical Subject Headings]
business.industry
atención ambulatoria
Public health
lcsh:RA1-1270
Health Care::Health Care Facilities
Manpower
and Services::Health Services::Patient Care::Ambulatory Care [Medical Subject Headings]
Patient Acceptance of Health Care
medicine.disease
Mental health
Investigación sobre Servicios de Salud
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Health Status Indicators::Severity of Illness Index [Medical Subject Headings]
Cross-Sectional Studies
Check Tags::Female [Medical Subject Headings]
Socioeconomic Factors
Spain
Linear Models
Ïndice de severidad de la enfermedad
business
estudios transversales
Zdroj: BMC Health Services Research, Vol 11, Iss 1, p 257 (2011)
BMC Health Services Research
Scopus-Elsevier
ISSN: 1472-6963
DOI: 10.1186/1472-6963-11-257
Popis: Background Persons with schizophrenia and related disorders may be particularly sensitive to a number of determinants of service use, including those related with illness, socio-demographic characteristics and organizational factors. The objective of this study is to identify factors associated with outpatient contacts at community mental health services of patients with schizophrenia or related disorders. Methods This cross-sectional study analyzed 1097 patients. The main outcome measure was the total number of outpatient consultations during one year. Independent variables were related to socio-demographic, clinical and use of service factors. Data were collected from clinical records. Results The multilevel linear regression model explained 46.35% of the variance. Patients with significantly more contacts with ambulatory services were not working and were receiving welfare benefits (p = 0.02), had no formal education (p = 0.02), had a global level of severity of two or three (four being the most severe) (p < 0.001), with one or more inpatient admissions (p < 0.001), and in contact with both types of professional (nurses and psychiatrists) (p < 0.001). The patients with the fewest ambulatory contacts were those with diagnoses of persistent delusional disorders (p = 0.04) and those who were attended by four of the 13 psychiatrists (p < 0.001). Conclusions As expected, the variables that explained the use of community service could be viewed as proxies for severity of illness. The most surprising finding, however, was that a group of four psychiatrists was also independently associated with use of ambulatory services by patients with schizophrenia or related disorders. More research is needed to carefully examine how professional support networks interact to affect use of mental health.
Databáze: OpenAIRE
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