Comparison of depression care provided in general practice in Norway and the Netherlands: registry-based cohort study (The Norwegian GP-DEP study)

BMC Health Services Research

Research

Derek de Beurs¹  Mark Nielen²  Valborg Baste³  Øystein Hetlevik⁴  Inger Haukenes⁴  Sabine Ruths⁴  Anneli Borge Hansen⁴  Tone Smith-Sivertsen⁵ 

[1] Department of Mental Health and Prevention, Trimbos Institute, Utrecht, The Netherlands;Netherlands Institute for Health Services Research, Utrecht, The Netherlands;Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway;Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway;Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway;Division of Psychiatry, Haukeland University Hospital, Bergen, Norway;

关键词: Mental health;    Large database research;    Health services research;    Depression;    General practice;    Antidepressive agents;    Drug therapy;    Prescriptions;   

DOI  :  10.1186/s12913-022-08793-7

 received in 2022-06-29, accepted in 2022-11-06,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundDepression is highly prevalent in general practice, and organisation of primary health care probably affects the provision of depression care. General practitioners (GPs) in Norway and the Netherlands fulfil comparable roles. However, primary care teams with a mental health nurse (MHN) supplementing the GP have been established in the Netherlands, but not yet in Norway. In order to explore how the organisation of primary mental care affects care delivery, we aimed to examine the provision of GP depression care across the two countries.MethodsRegistry-based cohort study comprising new depression episodes in patients aged ≥ 18 years, 2011–2015. The Norwegian sample was drawn from the entire population (national health registries); 297,409 episodes. A representative Dutch sample (Nivel Primary Care Database) was included; 27,362 episodes. Outcomes were follow-up consultation(s) with GP, with GP and/or MHN, and antidepressant prescriptions during 12 months from the start of the depression episode. Differences between countries were estimated using negative binomial and Cox regression models, adjusted for patient gender, age and comorbidity.ResultsPatients in the Netherlands compared to Norway were less likely to receive GP follow-up consultations, IRR (incidence rate ratio) = 0.73 (95% confidence interval (CI) 0.71–0.74). Differences were greatest among patients aged 18–39 years (adj IRR = 0.64, 0.63–0.66) and 40–59 years (adj IRR = 0.71, 0.69–0.73). When comparing follow-up consultations in GP practices, including MHN consultations in the Netherlands, no cross-national differences were found (IRR = 1.00, 0.98–1.01). But in age-stratified analyses, Dutch patients 60 years and older were more likely to be followed up than their Norwegian counterparts (adj IRR = 1.21, 1.16–1.26). Patients in the Netherlands compared to Norway were more likely to receive antidepressant drugs, adj HR (hazard ratio) = 1.32 (1.30–1.34).ConclusionsThe observed differences indicate that the organisation of primary mental health care affects the provision of follow-up consultations in Norway and the Netherlands. Clinical studies are needed to explore the impact of team-based care and GP-based care on the quality of depression care and patient outcomes.

【 授权许可】

CC BY   
© The Author(s) 2022

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