Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study)
Abstract Background Depression is highly prevalent in general practice, and organisation of primary health care probably affects the provision of depression care. General practitioners (GPs) in Norway and the Netherlands fulfil comparable roles. However, primary care teams with a mental health nurse...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-022-08793-7 |
| _version_ | 1811179111224180736 |
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| author | Anneli Borge Hansen Valborg Baste Øystein Hetlevik Tone Smith-Sivertsen Inger Haukenes Derek de Beurs Mark Nielen Sabine Ruths |
| author_facet | Anneli Borge Hansen Valborg Baste Øystein Hetlevik Tone Smith-Sivertsen Inger Haukenes Derek de Beurs Mark Nielen Sabine Ruths |
| author_sort | Anneli Borge Hansen |
| collection | DOAJ |
| description | Abstract Background Depression is highly prevalent in general practice, and organisation of primary health care probably affects the provision of depression care. General practitioners (GPs) in Norway and the Netherlands fulfil comparable roles. However, primary care teams with a mental health nurse (MHN) supplementing the GP have been established in the Netherlands, but not yet in Norway. In order to explore how the organisation of primary mental care affects care delivery, we aimed to examine the provision of GP depression care across the two countries. Methods Registry-based cohort study comprising new depression episodes in patients aged ≥ 18 years, 2011–2015. The Norwegian sample was drawn from the entire population (national health registries); 297,409 episodes. A representative Dutch sample (Nivel Primary Care Database) was included; 27,362 episodes. Outcomes were follow-up consultation(s) with GP, with GP and/or MHN, and antidepressant prescriptions during 12 months from the start of the depression episode. Differences between countries were estimated using negative binomial and Cox regression models, adjusted for patient gender, age and comorbidity. Results Patients in the Netherlands compared to Norway were less likely to receive GP follow-up consultations, IRR (incidence rate ratio) = 0.73 (95% confidence interval (CI) 0.71–0.74). Differences were greatest among patients aged 18–39 years (adj IRR = 0.64, 0.63–0.66) and 40–59 years (adj IRR = 0.71, 0.69–0.73). When comparing follow-up consultations in GP practices, including MHN consultations in the Netherlands, no cross-national differences were found (IRR = 1.00, 0.98–1.01). But in age-stratified analyses, Dutch patients 60 years and older were more likely to be followed up than their Norwegian counterparts (adj IRR = 1.21, 1.16–1.26). Patients in the Netherlands compared to Norway were more likely to receive antidepressant drugs, adj HR (hazard ratio) = 1.32 (1.30–1.34). Conclusions The observed differences indicate that the organisation of primary mental health care affects the provision of follow-up consultations in Norway and the Netherlands. Clinical studies are needed to explore the impact of team-based care and GP-based care on the quality of depression care and patient outcomes. |
| first_indexed | 2024-04-11T06:30:18Z |
| format | Article |
| id | doaj.art-28406fb159d343eb9239e344f90fc8d4 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-11T06:30:18Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-28406fb159d343eb9239e344f90fc8d42022-12-22T04:40:08ZengBMCBMC Health Services Research1472-69632022-12-0122111110.1186/s12913-022-08793-7Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study)Anneli Borge Hansen0Valborg Baste1Øystein Hetlevik2Tone Smith-Sivertsen3Inger Haukenes4Derek de Beurs5Mark Nielen6Sabine Ruths7Research Unit for General Practice, NORCE Norwegian Research CentreResearch Unit for General Practice, NORCE Norwegian Research CentreResearch Unit for General Practice, NORCE Norwegian Research CentreResearch Unit for General Practice, NORCE Norwegian Research CentreResearch Unit for General Practice, NORCE Norwegian Research CentreDepartment of Mental Health and Prevention, Trimbos InstituteNetherlands Institute for Health Services ResearchResearch Unit for General Practice, NORCE Norwegian Research CentreAbstract Background Depression is highly prevalent in general practice, and organisation of primary health care probably affects the provision of depression care. General practitioners (GPs) in Norway and the Netherlands fulfil comparable roles. However, primary care teams with a mental health nurse (MHN) supplementing the GP have been established in the Netherlands, but not yet in Norway. In order to explore how the organisation of primary mental care affects care delivery, we aimed to examine the provision of GP depression care across the two countries. Methods Registry-based cohort study comprising new depression episodes in patients aged ≥ 18 years, 2011–2015. The Norwegian sample was drawn from the entire population (national health registries); 297,409 episodes. A representative Dutch sample (Nivel Primary Care Database) was included; 27,362 episodes. Outcomes were follow-up consultation(s) with GP, with GP and/or MHN, and antidepressant prescriptions during 12 months from the start of the depression episode. Differences between countries were estimated using negative binomial and Cox regression models, adjusted for patient gender, age and comorbidity. Results Patients in the Netherlands compared to Norway were less likely to receive GP follow-up consultations, IRR (incidence rate ratio) = 0.73 (95% confidence interval (CI) 0.71–0.74). Differences were greatest among patients aged 18–39 years (adj IRR = 0.64, 0.63–0.66) and 40–59 years (adj IRR = 0.71, 0.69–0.73). When comparing follow-up consultations in GP practices, including MHN consultations in the Netherlands, no cross-national differences were found (IRR = 1.00, 0.98–1.01). But in age-stratified analyses, Dutch patients 60 years and older were more likely to be followed up than their Norwegian counterparts (adj IRR = 1.21, 1.16–1.26). Patients in the Netherlands compared to Norway were more likely to receive antidepressant drugs, adj HR (hazard ratio) = 1.32 (1.30–1.34). Conclusions The observed differences indicate that the organisation of primary mental health care affects the provision of follow-up consultations in Norway and the Netherlands. Clinical studies are needed to explore the impact of team-based care and GP-based care on the quality of depression care and patient outcomes.https://doi.org/10.1186/s12913-022-08793-7Mental healthLarge database researchHealth services researchDepressionGeneral practiceAntidepressive agents |
| spellingShingle | Anneli Borge Hansen Valborg Baste Øystein Hetlevik Tone Smith-Sivertsen Inger Haukenes Derek de Beurs Mark Nielen Sabine Ruths Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study) BMC Health Services Research Mental health Large database research Health services research Depression General practice Antidepressive agents |
| title | Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study) |
| title_full | Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study) |
| title_fullStr | Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study) |
| title_full_unstemmed | Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study) |
| title_short | Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study) |
| title_sort | comparison of depression care provided in general practice in norway and the netherlands registry based cohort study the norwegian gp dep study |
| topic | Mental health Large database research Health services research Depression General practice Antidepressive agents |
| url | https://doi.org/10.1186/s12913-022-08793-7 |
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