[Patterns of health services use and costs in patients with mental disorders in primary care].
OBJECTIVE
To determine the pattern of services use and costs of patients requiring care for mental disorders (MD) in primary care in the context of routine clinical practice.


METHODS
We performed a retrospective study of patients older than 15 consulting primary care at least once for MD, attended by 5 primary care teams in 2004. A comparative group was formed with the remaining outpatients without MD. The main measurements were age, gender, case-mix/comorbidity and health resource utilization and corresponding outpatient costs (drugs, diagnostic tests and visits). Multiple logistic regression analysis and ANCOVA models were applied.


RESULTS
A total of 64,072 patients were assessed, of which 11,128 had some type of MD (17.4%; 95% CI, 16.7-18.1). Patients consulting for MD had a greater number of health problems (6.7 vs. 4.7; p < 0.0001) and higher resource consumption, mainly all-type medical visits/patient/year (10.7 vs. 7.2; p < 0.0001). The mean annual cost per patient was higher for patients with MD (851.5 vs. 519.2 euros; p < 0.0001), and this difference remained significant after adjusting by age, sex and comorbidities, with a differential cost of euros 72.7 (95% CI, 59.2-85.9). All components of outpatient management costs were significantly higher in the MD group.


CONCLUSIONS
Outpatients seeking care for some type of MD had a high number of comorbidities and showed greater annual cost per patient in the primary care setting.
Dirección de Planificación, Badalona Serveis Assistencials, Badalona, Barcelona, España. asicras@bsa.gs
Antoni
A
Sicras Mainar
Javier
J
Rejas Gutiérrez
Ruth
R
Navarro Artieda
Josep
J
Serrat Tarrés
Milagrosa
M
Blanca Tamayo
Silvia
S
Díaz Cerezo
D000293:Adolescent; D000328:Adult; D000368:Aged; D003156:Community Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy*; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics*; D012189:Retrospective Studies