Gender Differences in Youth Suicide and Healthcare Service Use

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 290-298 ◽  
Author(s):  
Samantha Gontijo Guerra ◽  
Helen-Maria Vasiliadis
Keyword(s):  
Mental Health ◽  
Gender Differences ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Outpatient Services ◽  
Health Related ◽  
Healthcare Service Use ◽  
Ed Visits

Abstract. Background: Healthcare service use among suicide decedents must be well characterized and understood since a key strategy for preventing suicide is to improve healthcare providers' ability to effectively detect and treat those in need. Aims: To determine gender differences in healthcare service use 12 months prior to suicide. Method: Data for 1,231 young Quebec residents (≤ 25 years) who died by suicide between 2000 and 2007 were collected from public health insurance agency databases and coroner registers. Healthcare visits were categorized according to the setting (emergency department [ED], outpatient, and hospital) and their nature (mental health vs. non-mental health). Results: Girls were more likely than boys (82.5% vs. 74.9%, p = .011) to have used healthcare services in the year prior to death. A higher proportion of girls had used outpatient services (79.0% vs. 69.5%, p = .003), had been hospitalized (25.7% vs. 15.6%, p < .001) and had received a mental health-related diagnosis (46.7% vs. 33.1%, p < .001). However, no gender differences were observed in ED visits (59.5% vs. 54.5%, p = .150). Conclusion: There is an important proportion of suicide decedents who did not receive a mental health diagnosis and healthcare services in the year prior to death. Future studies should focus on examining gender-specific individual and health system barriers among suicide decedents as well as the quality of care offered regarding detection and treatment.

scholarly journals Self‐reported health, healthcare service use and health‐related needs: A comparison of older and younger homeless people

2019 ◽  
Vol 27 (4) ◽  
Author(s):  
Sophie I. van Dongen ◽  
Barbara van Straaten ◽  
Judith R. L. M. Wolf ◽  
Bregje D. Onwuteaka‐Philipsen ◽  
Agnes van der Heide ◽  
...  
Keyword(s):  
Healthcare Service ◽  
Service Use ◽  
Homeless People ◽  
Health Related ◽  
Healthcare Service Use ◽  
Reported Health

scholarly journals Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data

2021 ◽  
pp. tobaccocontrol-2021-056522
Author(s):  
Dolly Baliunas ◽  
Peter Selby ◽  
Claire de Oliveira ◽  
Paul Kurdyak ◽  
Laura Rosella ◽  
...  
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Healthcare Service ◽  
Service Use ◽  
Smoking Cessation Treatment ◽  
Outpatient Visits ◽  
Cessation Treatment ◽  
Healthcare Service Use ◽  
Ed Visits

BackgroundNo research has assessed the individual-level impact of smoking cessation treatment delivered within a general primary care patient population on multiple forms of subsequent healthcare service use.ObjectiveWe aimed to compare the rate of outpatient visits, emergency department (ED) visits and hospitalisations during a 5-year follow-up period among smokers who had and had not accessed a smoking cessation treatment programme.MethodsThe study was a retrospective matched cohort study using linked demographic and administrative healthcare databases in Ontario, Canada. 9951 patients who accessed smoking cessation services between July 2011 and December 2012 were matched to a smoker who did not access services, obtained from the Canadian Community Health Survey, using a combination of hard matching and propensity score matching. Outcomes were rates of healthcare service use from index date (programme enrolment or survey response) to March 2017.ResultsAfter controlling for potential confounders, patients in the overall treatment cohort had modestly greater rates of the outcomes: outpatient visits (rate ratio (RR) 1.10, 95% CI: 1.06 to 1.14), ED visits (RR 1.08, 95% CI: 1.03 to 1.13) and hospitalisations (RR 1.09, 95% CI: 1.02 to 1.18). Effect modification of the association between smoking cessation treatment and healthcare service use by prevalent comorbidity was found for outpatient visits (p=0.006), and hospitalisations (p=0.050), but not ED visits.ConclusionsPatients who enrolled in smoking cessation treatment offered through primary care clinics in Ontario displayed a modest but significantly greater rate of outpatient visits, ED visits and hospitalisations over a 5-year follow-up period.

scholarly journals Trends in the utilization of youth primary healthcare services and psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract BackgroundPsychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.MethodsThis study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. ResultsWe found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.ConclusionsOur findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

scholarly journals Adolescents' mental health, help seeking and service use and parents' perception of family functioning

2018 ◽  
Vol 39 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Øyfrid Larsen Moen ◽  
Marie Louise Hall-Lord
Keyword(s):  
Mental Health ◽  
Family Functioning ◽  
Help Seeking ◽  
Service Use ◽  
Healthcare Services ◽  
Open Door Policy ◽  
Cross Sectional ◽  
Hyperactivity Disorder ◽  
Healthcare Service Use ◽  
Cross Sectional Design

The adolescent population is facing mental-health challenges such as depression and anxiety. The aim of this study was to describe and investigate the mental health of adolescents, their relation to their parents, who they contact for help and their healthcare service use. A further objective was to describe and investigate family functioning in parents. A cross-sectional design was employed using register data from a survey of adolescents ( n = 46,961), and surveys were conducted of two groups of parents – one group of parents with children with attention deficit hyperactivity disorder ( n = 264) and one group of parents with school children ( n = 157). Descriptive and comparative statistics were used. Of the adolescents, 5.65% were quite distressed. This group of adolescents would be less likely to seek help from friends and parents than the other adolescents. They were also more likely to use all types of healthcare services, and parents reported that they avoided discussing fears and concerns. School nurses are low-threshold professionals who can contribute in early support and interventions, providing service to all school pupils with an open-door policy. The use of family conversations focusing on strengths and resources may help the families to talk about difficult matters and highlight the resources in the family.

scholarly journals Trends in the utilization of youth primary healthcare services and psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 300 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

scholarly journals Trends in the utilization of youth primary healthcare services for psychological distress

2020 ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the relationship between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need. Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 ( n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time.Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 300 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16-66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

Towards Zero Suicide for older adults: implications of healthcare service use for implementation

2021 ◽  
pp. 103985622110540
Author(s):  
Roderick McKay ◽  
Dimity Pond ◽  
Anne Wand
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older People ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Utilisation ◽  
Pathways To Care ◽  
Expert Assessment ◽  
Complex Needs ◽  
Healthcare Service Use

Objective: Implementing the Towards Zero Suicide (TZS) approach to suicide prevention in older adults requires evidence-based adaptation. This paper aims to highlight important differences and opportunities in healthcare service use by older adults relevant to implementation. Conclusion: The TZS approach may prevent suicide in older adults, but only if implementation aligns with systemic differences in healthcare utilisation by older people. Of greatest importance in older adults are (1) most mental healthcare is delivered outside of specialist mental health services; (2) physical conditions and disability are major modifiable contributors to suicide that must be addressed within TZS; and (3) older people have very low use of Medicare-funded psychological services. Primary healthcare providers, who may be seeing older people at risk of suicide, are often neither equipped to provide expert assessment and care planning for often complex needs, nor may see this as their role. However, they are essential in providing pathways to care, which may prevent suicide. Leaders must recognise TZS for older people will usually involve multiple transitions. This requires engagement of key services with clear roles, targeted training, rapid access to specialist older persons mental health support and development of a new TZS element: the navigator.

scholarly journals Homelessness at discharge and its impact on psychiatric readmission and physician follow-up: a population-based cohort study

2019 ◽  
Vol 29 ◽  
Author(s):  
V. Laliberté ◽  
V. Stergiopoulos ◽  
B. Jacob ◽  
P. Kurdyak
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Outpatient Care ◽  
Service Use ◽  
Significant Proportion ◽  
Population Based ◽  
Psychiatric Hospitalisation ◽  
Health Related ◽  
Ed Visits ◽  
The Impact

Abstract Aims A significant proportion of adults who are admitted to psychiatric hospitals are homeless, yet little is known about their outcomes after a psychiatric hospitalisation discharge. The aim of this study was to assess the impact of being homeless at the time of psychiatric hospitalisation discharge on psychiatric hospital readmission, mental health-related emergency department (ED) visits and physician-based outpatient care. Methods This was a population-based cohort study using health administrative databases. All patients discharged from a psychiatric hospitalisation in Ontario, Canada, between 1 April 2011 and 31 March 2014 (N = 91 028) were included and categorised as homeless or non-homeless at the time of discharge. Psychiatric hospitalisation readmission rates, mental health-related ED visits and physician-based outpatient care were measured within 30 days following hospital discharge. Results There were 2052 (2.3%) adults identified as homeless at discharge. Homeless individuals at discharge were significantly more likely to have a readmission within 30 days following discharge (17.1 v. 9.8%; aHR = 1.43 (95% CI 1.26–1.63)) and to have an ED visit (27.2 v. 11.6%; aHR = 1.87 (95% CI 1.68–2.0)). Homeless individuals were also over 50% less likely to have a psychiatrist visit (aHR = 0.46 (95% CI 0.40–0.53)). Conclusion Homeless adults are at higher risk of readmission and ED visits following discharge. They are also much less likely to receive post-discharge physician care. Efforts to improve access to services for this vulnerable population are required to reduce acute care service use and improve care continuity.

scholarly journals Healthcare Service Use, Costs, and Treatment Patterns within a Cohort of Experienced and New Users of Preventive Migraine Medications

2020 ◽  
Author(s):  
Machaon Bonafede ◽  
Sandhya Sapra ◽  
Stewart Tepper ◽  
Katherine Cappell ◽  
Pooja Desai
Keyword(s):  
Healthcare Costs ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Patient Functioning ◽  
Treatment Regimens ◽  
Level Of Functioning ◽  
Healthcare Service Use ◽  
Improve Patient

Abstract Background: Migraine is a debilitating disease associated with increased use of healthcare services. Pharmacological interventions include acute medications to reduce symptoms and restore patient functioning, and preventive migraine medications (PMM), to reduce frequency, duration, and intensity of migraine symptoms . This study examined treatment and associated healthcare service use and costs between PMM naïve and experienced patients.Methods: Migraine patients initiating treatment with a PMM from January 1, 2010-June 30,2014 were identified in the IBM MarketScan Commercial and Medicare Supplemental Databases. Migraine medication use, service utilization, and costs were examined over the 12 months following PMM initiation; outcomes were compared between patients experienced with and naïve to PMM treatment.Results: Adherence and persistence with PMMs was low, with only 24% of patients adherent to their index PMM. Rates of discontinuation were high, with 71.4% of the sample discontinuing their PMM over the 12-month follow up. Utilization of acute medications was common, as was PMM switching in experienced patients. Annual healthcare costs were $12,044 and $19,093 for the PMM naïve and experienced populations respectively. Migraine-specific service use accounted for approximately 20% of all-cause healthcare costs. The PMM experienced cohort consistently evidenced higher service use and costs than the PMM naïve cohort.Conclusion: Utilization of PMM remains suboptimal and is accompanied by both lack of PMM adherence and high use of acute medications. Rates of PMM switching and use of acute medications suggest that patients have unmet needs regarding migraine management. Improved treatment regimens that effectively manage migraine symptoms are needed to improve patient level of functioning while reducing healthcare costs associated with migraine management.

scholarly journals Trends in the utilization of youth primary healthcare services and psychological distress

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thomas Potrebny ◽  
Nora Wiium ◽  
Anne Haugstvedt ◽  
Ragnhild Sollesnes ◽  
Bente Wold ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Primary Healthcare ◽  
Help Seeking ◽  
Healthcare Service ◽  
Service Use ◽  
Healthcare Services ◽  
Seeking Behavior ◽  
Healthcare Service Use ◽  
Low Levels

Abstract Background Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need. Methods This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13–19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. Results We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16 and 66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend. Conclusions Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

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