Receipt of preventive medical care and medical screening for patients with mental illness: a comparative analysis.
BACKGROUND
There has been long-standing concern about the delivery of preventive and screening services to patients with mental illness.


OBJECTIVE
We aimed to examine whether the quality of preventive care received by patients with mental health conditions differs from that received by individuals who have no comparable mental disorder. Our hypothesis was that patients with mental illness would be in receipt of lower quality or lower frequency of preventive care.


METHODS
Studies that examined the quality of care in those with and without comorbid mental illness were reviewed and comparative data extracted. By using only comparative studies we hope to ascertain whether inequalities in care existed by virtue of psychiatric diagnoses (or closely affiliated factors).


RESULTS
We identified 26 studies that examined preventive care in individuals with vs. without psychiatric illness. From these eligible studies, 61 comparisons were documented across 13 health care domains. These included mammography, cervical smears, vaccinations, cholesterol screening, lifestyle counseling, colonoscopy. Twenty-seven comparisons revealed inferior preventive health care in those with mental illness, but 10 suggested superior preventive health care and 24 reached inconclusive findings. Inferior preventive care was most apparent in those with schizophrenia and in relation to osteoporosis screening, blood pressure monitoring, vaccinations, mammography and cholesterol monitoring.


CONCLUSIONS
We conclude there is strong evidence to suggest that the quality of preventive and screening services received by patients with mental illness is often lower, but occasionally superior to that received by individuals who have no comparable mental disorder. More work must be done to improve the quality of medical and preventive care for individuals with mental illness.
Lord
Oliver
O
Leicester Partnership Trust, Leicester, UK.
Malone
Darren
D
Mitchell
Alex J
AJ
D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010348:Patient Care Team / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014600:Utilization Review / Q000706:statistics & numerical data