Patients with mental illness in primary health care. A long-term follow- up of health care utilization and contact patterns with psychiatric care

Abstract

Objective - Long-term follow-up of the use of health care services in patients with a mental illness identified in primary care. A 10-year follow- up of all health care utilization in five 1-year cohorts of patients with a mental illness identified in primary health care services of a Swedish health care district. Patients - 1167 (408 males, 759 females) with mental illness. Results - A total of 27.1% of the patients were in contact with psychiatric services during follow-up. The strongest associations with contact with psychiatric services concerned age (younger) and diagnosis (dependence, affective psychosis). Patients with a diagnosis of psychosis had the highest utilization of psychiatric services. Patients in contact with psychiatric care had a higher consumption of primary health care and of somatic outpatient and inpatient care. A subgroup identified as high consumers consumed 44% of the total health care resources used by the cohort. Conclusion - The use of health care services was very skewed. Patients in contact with psychiatric services were more frequent users of other medical services.