Potential for substitution of mental health care towards family practices: an observational study

BMC Family Practice

Research Article

Tessa Magnée¹  Derek P. de Beurs¹  Peter F. Verhaak²  Dinny H. de Bakker³  Richard Boxem⁴ 

[1] Netherlands Institute of Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands;Netherlands Institute of Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands;Department of General Practice, Groningen University, Groningen, The Netherlands;Netherlands Institute of Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands;Tilburg University, Scientific Centre for Transformation in Care and Welfare (TRANZO), Tilburg, The Netherlands;The Dutch Healthcare Authority, Utrecht, The Netherlands;

关键词: Family practice;    Mental health;    Psychiatric disorders;    Primary care;    Health services;   

DOI  :  10.1186/s12875-017-0586-4

 received in 2016-07-14, accepted in 2017-01-19,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSubstitution is the shift of care from specialized health care to less expensive and more accessible primary health care. It seems promising for restraining rising mental health care costs. The goal of this study was to investigate a potential for substitution of patients with psychological or social problems, but without severe psychiatric disorders, from Dutch specialized mental health care to primary care, especially family practices.MethodsWe extracted anonymized data from two national databases representing primary and specialized care in 2012. We calculated the number of patients with and without psychiatric disorder per 1,000 citizens in three major settings: family practices, primary care psychologists, and specialized care. Family physicians recorded psychopathology using the International Classification of Primary Care, while psychologists and specialists used the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition.ResultsConsiderable numbers of patients without a diagnosed DSM-IV psychiatric disorder were treated by primary care psychologists (32.8%) or in specialized care (20.8%). Over half of the patients referred by family physicians to mental health care did not have a psychiatric disorder.ConclusionA recent reform of Dutch mental health care, including new referral criteria, will likely increase the number of patients with psychological or social problems that family physicians have to treat or support. Enabling and improving diagnostic assessment and treatment in family practices seems essential for substitution of mental health care.

【 授权许可】

CC BY   
© The Author(s). 2017