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

Abstract：

BACKGROUND: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. METHODS: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. RESULTS: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). CONCLUSIONS: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.

journal_name

BMC Health Serv Res

journal_title

BMC health services research

authors

Moreno-Küstner B,Mayoral F,Rivas F,Angona P,Requena J,García-Herrera JM,Navas D,Moreno P,Serrano-Blanco A,Bellón JA

doi

10.1186/1472-6963-11-257

subject

Has Abstract

pub_date

2011-10-07 00:00:00

pages

257

issn

1472-6963

pii

1472-6963-11-257

journal_volume

pub_type

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