PTSD symptom clusters associated with physical health and health care utilization in rural primary care patients exposed to natural disaster

2008 ◽  
Vol 21 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Melissa A. Polusny ◽  
Barry J. Ries ◽  
Jessica R. Schultz ◽  
Patrick Calhoun ◽  
Lisa Clemensen ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Utilization ◽  
Physical Health ◽  
Natural Disaster ◽  
Ptsd Symptom ◽  
Symptom Clusters ◽  
Care Utilization ◽  
Rural Primary Care ◽  
Primary Care Patients

Depression in Primary Care—More like Asthma Than Appendicitis: The Michigan Depression Project

1997 ◽  
Vol 42 (9) ◽  
pp. 966-973 ◽  
Author(s):  
Michael S Klinkman ◽  
Thomas L Schwenk ◽  
James C Coyne
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Health Care ◽  
Health Care Utilization ◽  
Family Practice ◽  
Care Setting ◽  
Primary Care Setting ◽  
Past History ◽  
Care Utilization ◽  
Primary Care Patients

Objective: To explore the relationships between detection, treatment, and outcome of depression in the primary care setting, based upon results from the Michigan Depression Project (MDP). Methods: A weighted sample of 425 adult family practice patients completed a comprehensive battery of questionnaires exploring stress, social support, overall health, health care utilization, treatment attitudes, self-rated levels of stress and depression, along with the Center for Epidemiologic Studies Depression Scale (CES-D), the Hamilton Rating Scale for Depression (HAM-D), and the Structured Clinical Interview for DSM-III (SCID), which served as the criterion standard for diagnosis. A comparison sample of 123 depressed psychiatric outpatients received the same assessment battery. Family practice patients received repeated assessment of depressive symptoms, stress, social support, and health care utilization over a period of up to 60 months of longitudinal follow-up. Results: The central MDP findings confirm that significant differences in past history, severity, and impairment exist between depressed psychiatric and family practice patients, that detection rates are significantly higher for severely depressed primary care patients, and that clinicians use clinical cues such as past history, distress, and severity of symptoms to “detect” depression in patients at intermediate and mild levels of severity. As well, there is a lack of association between detection and improved outcome in primary care patients. Conclusion: These results call into question the assumption that “depression is depression” irrespective of the setting and physician, and they are consistent with a model of depressive disorder as a subacute or chronic condition characterized by clinical parameters of severity, staging, and comorbidity, similar to asthma. This new model can guide further investigation into the epidemiology and management of mood disorders in the primary care setting.

scholarly journals Loneliness in Primary Care Patients: Relationships With Body Mass Index and Health Care Utilization

2021 ◽  
Vol 8 (3) ◽  
pp. 239-247
Author(s):  
Tamara K Oser ◽  
Siddhartha Roy ◽  
Jessica Parascando ◽  
Rebecca Mullen ◽  
Julie Radico ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Body Mass Index ◽  
Health Care Utilization ◽  
Body Mass ◽  
Care Utilization ◽  
Primary Care Patients

Health Perceptions of Primary Care Patients and the Influence on Health Care Utilization

Medical Care ◽  
1989 ◽  
Vol 27 (Supplement) ◽  
pp. S99-S109 ◽  
Author(s):  
Julia E. Connelly ◽  
John T. Philbrick ◽  
G Richard Smith ◽  
Donald L. Kaiser ◽  
Antoinette Wymer
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Utilization ◽  
Health Perceptions ◽  
Care Utilization ◽  
Primary Care Patients

Drinking patterns, health care utilization, and costs among HMO primary care patients

2001 ◽  
Vol 28 (4) ◽  
pp. 378-399 ◽  
Author(s):  
Michael R. Polen ◽  
Carla A. Green ◽  
Donald K. Freeborn ◽  
John P. Mullooly ◽  
Frances Lynch
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Drinking Patterns ◽  
Primary Care Patients

scholarly journals The employment and mental health impact of integrated improving access to psychological therapies services: Evidence on secondary health care utilization from a pragmatic trial in three English counties

2021 ◽  
pp. 135581962199749
Author(s):  
Veronica Toffolutti ◽  
David Stuckler ◽  
Martin McKee ◽  
Ineke Wolsey ◽  
Judith Chapman ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Physical Health ◽  
Health Problems ◽  
Care Utilization ◽  
Psychological Therapies ◽  
Physical Health Problems ◽  
Secondary Health Care

Objective Patients with a combination of long-term physical health problems can face barriers in obtaining appropriate treatment for co-existing mental health problems. This paper evaluates the impact of integrating the improving access to psychological therapies services (IAPT) model with services addressing physical health problems. We ask whether such services can reduce secondary health care utilization costs and improve the employment prospects of those so affected. Methods We used a stepped-wedge design of two cohorts of a total of 1,096 patients with depression and/or anxiety and comorbid long-term physical health conditions from three counties within the Thames Valley from March to August 2017. Panels were balanced. Difference-in-difference models were employed in an intention-to-treat analysis. Results The new Integrated-IAPT was associated with a decrease of 6.15 (95% CI: −6.84 to −5.45) [4.83 (95% CI: −5.47 to −4.19]) points in the Patient Health Questionnaire-9 [generalized anxiety disorder-7] and £360 (95% CI: –£559 to –£162) in terms of secondary health care utilization costs per person in the first three months of treatment. The Integrated-IAPT was also associated with an 8.44% (95% CI: 1.93% to 14.9%) increased probability that those who were unemployed transitioned to employment. Conclusions Mental health treatment in care model with Integrated-IAPT seems to have significantly reduced secondary health care utilization costs among persons with long-term physical health conditions and increased their probability of employment.

scholarly journals Health status and health care utilization after discharge from geriatric in-hospital stay – description of a register-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
E. Rydwik ◽  
R. Lindqvist ◽  
C. Willers ◽  
L. Carlsson ◽  
G. H. Nilsson ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Status ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Future Studies ◽  
Healthcare Data ◽  
Utilization Data ◽  
Hospital Stays ◽  
Socioeconomic Data

Abstract Background This study is the first part of a register-based research program with the overall aim to increase the knowledge of the health status among geriatric patients and to identify risk factors for readmission in this population. The aim of this study was two-fold: 1) to evaluate the validity of the study cohorts in terms of health care utilization in relation to regional cohorts; 2) to describe the study cohorts in terms of health status and health care utilization after discharge. Methods The project consist of two cohorts with data from patient records of geriatric in-hospital stays, health care utilization data from Stockholm Regional Healthcare Data Warehouse 6 months after discharge, socioeconomic data from Statistics Sweden. The 2012 cohort include 6710 patients and the 2016 cohort, 8091 patients; 64% are women, mean age is 84 (SD 8). Results Mean days to first visit in primary care was 12 (23) and 10 (19) in the 2012 and 2016 cohort, respectively. Readmissions to hospital was 38% in 2012 and 39% in 2016. The validity of the study cohorts was evaluated by comparing them with regional cohorts. The study cohorts were comparable in most cases but there were some significant differences between the study cohorts and the regional cohorts, especially regarding amount and type of primary care. Conclusion The study cohorts seem valid in terms of health care utilization compared to the regional cohorts regarding hospital care, but less so regarding primary care. This will be considered in the analyses and when interpreting data in future studies based on these study cohorts. Future studies will explore factors associated with health status and re-admissions in a population with multi-morbidity and disability.

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