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

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.

Category

Academic article

Language

English

Author(s)

  • Torhild Heggestad
  • Solfrid Lilleeng
  • Torleif Ruud

Affiliation

  • Bergen Hospital Trust - Haukeland University Hospital
  • SINTEF Digital / Health Research
  • Norwegian Directorate of Health
  • Akershus University Hospital Trust
  • University of Oslo

Year

2011

Published in

Social Psychiatry and Psychiatric Epidemiology

ISSN

0933-7954

Publisher

Springer

Volume

46

Issue

12

Page(s)

1275 - 1282

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