From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy
ObjectivesTo measure the gap between contact and effective coverage of mental healthcare (MHC).Materials and methods45,761 newly referred cases of depression, schizophrenia, bipolar disorder, and personality disorder from four Italian regions were included. A variant of the self-controlled case seri...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1014193/full |
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| author | Giovanni Corrao Giovanni Corrao Matteo Monzio Compagnoni Matteo Monzio Compagnoni Angelo Barbato Barbara D’Avanzo Teresa Di Fiandra Lucia Ferrara Andrea Gaddini Alessio Saponaro Salvatore Scondotto Salvatore Scondotto Valeria D. Tozzi Flavia Carle Flavia Carle Simona Carbone Daniel H. Chisholm Antonio Lora Antonio Lora |
| author_facet | Giovanni Corrao Giovanni Corrao Matteo Monzio Compagnoni Matteo Monzio Compagnoni Angelo Barbato Barbara D’Avanzo Teresa Di Fiandra Lucia Ferrara Andrea Gaddini Alessio Saponaro Salvatore Scondotto Salvatore Scondotto Valeria D. Tozzi Flavia Carle Flavia Carle Simona Carbone Daniel H. Chisholm Antonio Lora Antonio Lora |
| author_sort | Giovanni Corrao |
| collection | DOAJ |
| description | ObjectivesTo measure the gap between contact and effective coverage of mental healthcare (MHC).Materials and methods45,761 newly referred cases of depression, schizophrenia, bipolar disorder, and personality disorder from four Italian regions were included. A variant of the self-controlled case series method was adopted to estimate the incidence rate ratio (IRR) for the relationship between exposure (i.e., use of different types of MHC such as pharmacotherapy, generic contact with the outpatient services, psychosocial intervention, and psychotherapy) and relapse (emergency hospital admissions for mental illness).Results11,500 relapses occurred. Relapse risk was reduced during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI: 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99), and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for patients with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic care, in absence of psychosocial/psychotherapeutic interventions, did not affect risk of relapse.ConclusionThis study ascertained the gap between contact and effective coverage of MHC and showed that administrative data can usefully contribute to assess the effectiveness of a mental health system. |
| first_indexed | 2024-04-12T06:22:55Z |
| format | Article |
| id | doaj.art-ba557aeaf8564c61b58d4f466f0d7a0b |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-12T06:22:55Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-ba557aeaf8564c61b58d4f466f0d7a0b2022-12-22T03:44:16ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-11-011310.3389/fpsyt.2022.10141931014193From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from ItalyGiovanni Corrao0Giovanni Corrao1Matteo Monzio Compagnoni2Matteo Monzio Compagnoni3Angelo Barbato4Barbara D’Avanzo5Teresa Di Fiandra6Lucia Ferrara7Andrea Gaddini8Alessio Saponaro9Salvatore Scondotto10Salvatore Scondotto11Valeria D. Tozzi12Flavia Carle13Flavia Carle14Simona Carbone15Daniel H. Chisholm16Antonio Lora17Antonio Lora18National Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, ItalyUnit of Biostatistics, Epidemiology, and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, ItalyNational Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, ItalyUnit of Biostatistics, Epidemiology, and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, ItalyDepartment of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, ItalyDepartment of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, ItalyPreviously General Directorate for Health Prevention, Italian Health Ministry, Rome, ItalyCenter of Research on Health and Social Care Management, SDA Bocconi School of Management (Bocconi University), Milan, ItalyAgency for Public Health, Rome, ItalyGeneral Directorate of Health and Social Policies, Bologna, ItalyNational Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, ItalyDepartment of Health Services and Epidemiological Observatory, Regional Health Authority, Palermo, ItalyCenter of Research on Health and Social Care Management, SDA Bocconi School of Management (Bocconi University), Milan, ItalyNational Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, ItalyCenter of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy0Department of Health Planning, Italian Health Ministry, Rome, Italy1Department of Mental Health and Substance Abuse, World Health Organization, Geneva, SwitzerlandNational Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy2Department of Mental Health and Addiction Services, ASST Lecco, Lecco, ItalyObjectivesTo measure the gap between contact and effective coverage of mental healthcare (MHC).Materials and methods45,761 newly referred cases of depression, schizophrenia, bipolar disorder, and personality disorder from four Italian regions were included. A variant of the self-controlled case series method was adopted to estimate the incidence rate ratio (IRR) for the relationship between exposure (i.e., use of different types of MHC such as pharmacotherapy, generic contact with the outpatient services, psychosocial intervention, and psychotherapy) and relapse (emergency hospital admissions for mental illness).Results11,500 relapses occurred. Relapse risk was reduced during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI: 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99), and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for patients with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic care, in absence of psychosocial/psychotherapeutic interventions, did not affect risk of relapse.ConclusionThis study ascertained the gap between contact and effective coverage of MHC and showed that administrative data can usefully contribute to assess the effectiveness of a mental health system.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1014193/fulleffective coveragemental healthcarehealth service researchquality of healthcarehealthcare utilization database |
| spellingShingle | Giovanni Corrao Giovanni Corrao Matteo Monzio Compagnoni Matteo Monzio Compagnoni Angelo Barbato Barbara D’Avanzo Teresa Di Fiandra Lucia Ferrara Andrea Gaddini Alessio Saponaro Salvatore Scondotto Salvatore Scondotto Valeria D. Tozzi Flavia Carle Flavia Carle Simona Carbone Daniel H. Chisholm Antonio Lora Antonio Lora From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy Frontiers in Psychiatry effective coverage mental healthcare health service research quality of healthcare healthcare utilization database |
| title | From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy |
| title_full | From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy |
| title_fullStr | From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy |
| title_full_unstemmed | From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy |
| title_short | From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy |
| title_sort | from contact coverage to effective coverage of community care for patients with severe mental disorders a real world investigation from italy |
| topic | effective coverage mental healthcare health service research quality of healthcare healthcare utilization database |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1014193/full |
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