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The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study
BACKGROUND: Emerging evidence indicates an association between mental illness and poor quality of physical health care. To test this, we compared mental health clients (MHCs) with non-MHCs on potentially preventable hospitalisations (PPHs) as an indicator of the quality of primary care received. MET...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201897/ https://www.ncbi.nlm.nih.gov/pubmed/21985082 http://dx.doi.org/10.1186/1471-244X-11-163 |
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author | Mai, Qun Holman, C D'Arcy J Sanfilippo, Frank M Emery, Jonathan D |
author_facet | Mai, Qun Holman, C D'Arcy J Sanfilippo, Frank M Emery, Jonathan D |
author_sort | Mai, Qun |
collection | PubMed |
description | BACKGROUND: Emerging evidence indicates an association between mental illness and poor quality of physical health care. To test this, we compared mental health clients (MHCs) with non-MHCs on potentially preventable hospitalisations (PPHs) as an indicator of the quality of primary care received. METHODS: Population-based retrospective cohort study of 139,208 MHCs and 294,180 matched non-MHCs in Western Australia from 1990 to 2006, using linked data from electoral roll registrations, mental health registry (MHR) records, hospital inpatient discharges and deaths. We used the electoral roll data as the sampling frame for both cohorts to enhance internal validity of the study, and the MHR to separate MHCs from non-MHCs. Rates of PPHs (overall and by PPH category and medical condition) were compared between MHCs, category of mental disorders and non-MHCs. Multivariate negative binomial regression analyses adjusted for socio-demographic factors, case mix and the year at the start of follow up due to dynamic nature of study cohorts. RESULTS: PPHs accounted for more than 10% of all hospital admissions in MHCs, with diabetes and its complications, adverse drug events (ADEs), chronic obstructive pulmonary disease (COPD), convulsions and epilepsy, and congestive heart failure being the most common causes. Compared with non-MHCs, MHCs with any mental disorders were more likely to experience a PPH than non-MHCs (overall adjusted rate ratio (ARR) 2.06, 95% confidence interval (CI) 2.03-2.09). ARRs of PPHs were highest for convulsions and epilepsy, nutritional deficiencies, COPD and ADEs. The ARR of a PPH was highest in MHCs with alcohol/drug disorders, affective psychoses, other psychoses and schizophrenia. CONCLUSIONS: MHCs have a significantly higher rate of PPHs than non-MHCs. Improving primary and secondary prevention is warranted in MHCs, especially at the primary care level, despite there may be different thresholds for admission in people with established physical disease that is influenced by whether or not they have comorbid mental illness. |
format | Online Article Text |
id | pubmed-3201897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32018972011-10-26 The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study Mai, Qun Holman, C D'Arcy J Sanfilippo, Frank M Emery, Jonathan D BMC Psychiatry Research Article BACKGROUND: Emerging evidence indicates an association between mental illness and poor quality of physical health care. To test this, we compared mental health clients (MHCs) with non-MHCs on potentially preventable hospitalisations (PPHs) as an indicator of the quality of primary care received. METHODS: Population-based retrospective cohort study of 139,208 MHCs and 294,180 matched non-MHCs in Western Australia from 1990 to 2006, using linked data from electoral roll registrations, mental health registry (MHR) records, hospital inpatient discharges and deaths. We used the electoral roll data as the sampling frame for both cohorts to enhance internal validity of the study, and the MHR to separate MHCs from non-MHCs. Rates of PPHs (overall and by PPH category and medical condition) were compared between MHCs, category of mental disorders and non-MHCs. Multivariate negative binomial regression analyses adjusted for socio-demographic factors, case mix and the year at the start of follow up due to dynamic nature of study cohorts. RESULTS: PPHs accounted for more than 10% of all hospital admissions in MHCs, with diabetes and its complications, adverse drug events (ADEs), chronic obstructive pulmonary disease (COPD), convulsions and epilepsy, and congestive heart failure being the most common causes. Compared with non-MHCs, MHCs with any mental disorders were more likely to experience a PPH than non-MHCs (overall adjusted rate ratio (ARR) 2.06, 95% confidence interval (CI) 2.03-2.09). ARRs of PPHs were highest for convulsions and epilepsy, nutritional deficiencies, COPD and ADEs. The ARR of a PPH was highest in MHCs with alcohol/drug disorders, affective psychoses, other psychoses and schizophrenia. CONCLUSIONS: MHCs have a significantly higher rate of PPHs than non-MHCs. Improving primary and secondary prevention is warranted in MHCs, especially at the primary care level, despite there may be different thresholds for admission in people with established physical disease that is influenced by whether or not they have comorbid mental illness. BioMed Central 2011-10-10 /pmc/articles/PMC3201897/ /pubmed/21985082 http://dx.doi.org/10.1186/1471-244X-11-163 Text en Copyright ©2011 Mai et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Mai, Qun Holman, C D'Arcy J Sanfilippo, Frank M Emery, Jonathan D The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study |
title | The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study |
title_full | The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study |
title_fullStr | The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study |
title_full_unstemmed | The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study |
title_short | The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study |
title_sort | impact of mental illness on potentially preventable hospitalisations: a population-based cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201897/ https://www.ncbi.nlm.nih.gov/pubmed/21985082 http://dx.doi.org/10.1186/1471-244X-11-163 |
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