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

<p>Abstract</p> <p>Background</p> <p>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 object...

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Main Authors: Moreno Patricia, Navas Desiree, García-Herrera José M, Requena Javier, Angona Pedro, Mayoral Fermín, Rivas Fabio, Moreno-Küstner Berta, Serrano-Blanco Antoni, Bellón Juan A
Format: Article
Language:English
Published: BMC 2011-10-01
Series:BMC Health Services Research
Online Access:http://www.biomedcentral.com/1472-6963/11/257
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author Moreno Patricia
Navas Desiree
García-Herrera José M
Requena Javier
Angona Pedro
Mayoral Fermín
Rivas Fabio
Moreno-Küstner Berta
Serrano-Blanco Antoni
Bellón Juan A
author_facet Moreno Patricia
Navas Desiree
García-Herrera José M
Requena Javier
Angona Pedro
Mayoral Fermín
Rivas Fabio
Moreno-Küstner Berta
Serrano-Blanco Antoni
Bellón Juan A
author_sort Moreno Patricia
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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).</p> <p>Conclusions</p> <p>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.</p>
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spelling doaj.art-63012e8b765e4e3380a312f0c2c347402022-12-22T01:25:05ZengBMCBMC Health Services Research1472-69632011-10-0111125710.1186/1472-6963-11-257Factors associated with use of community mental health services by schizophrenia patients using multilevel analysisMoreno PatriciaNavas DesireeGarcía-Herrera José MRequena JavierAngona PedroMayoral FermínRivas FabioMoreno-Küstner BertaSerrano-Blanco AntoniBellón Juan A<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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).</p> <p>Conclusions</p> <p>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.</p>http://www.biomedcentral.com/1472-6963/11/257
spellingShingle Moreno Patricia
Navas Desiree
García-Herrera José M
Requena Javier
Angona Pedro
Mayoral Fermín
Rivas Fabio
Moreno-Küstner Berta
Serrano-Blanco Antoni
Bellón Juan A
Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis
BMC Health Services Research
title Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis
title_full Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis
title_fullStr Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis
title_full_unstemmed Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis
title_short Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis
title_sort factors associated with use of community mental health services by schizophrenia patients using multilevel analysis
url http://www.biomedcentral.com/1472-6963/11/257
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