Patterns of service utilisation in psychosis: findings of the 2010 Australian national survey of psychosis.
OBJECTIVE
This paper reports patterns of health service utilisation in the second Australian national survey of psychosis corresponding with changes in available services of this period.


METHODS
Semi-structured interviews were carried out of an age-stratified random sample of adults who screened positive for psychosis. Multivariate logistic regressions were used to identify predictors of service use for a sample of 1825 individuals.


RESULTS
Use of psychiatric inpatient services was associated with higher symptom levels, suicidal ideation, poor social functioning and younger age. High users of emergency mental health services similarly reported higher symptom levels, poor functioning and younger age, and also reported being married or in a de facto relationship. Recipients of general practitioner services had greater anxiety symptoms and suicidal thoughts, fewer negative symptoms, single marital status and English as their first language. Rehabilitation service use was associated with greater anxiety symptoms, unemployment, younger age of illness onset, living alone and having no dependent children living at home. Last, outpatient/community services were more frequently used by younger people with good premorbid adjustment, hallucinations and a less severe course of illness.


CONCLUSIONS
Service utilisation patterns vary with the clinical and socio-demographic features of those who use them - inpatient and emergency service users being similar in such features and differing from users of other services. Comparison with the first national survey of psychosis revealed a significant decline in acute inpatient service use and a substantial increase in the use of outpatient/community and rehabilitation services over the past 10 years.
1School of Psychiatry, University of New South Wales, Sydney, Australia.
Alessandra
A
Raudino
Vaughan J
VJ
Carr
Robert
R
Bush
Suzy
S
Saw
Philip
P
Burgess
Vera A
VA
Morgan
D000328:Adult; D001315:Australia; D003156:Community Mental Health Services / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D011618:Psychotic Disorders / Q000628:therapy*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data* / Q000639:trends; D012307:Risk Factors
National survey; psychotic disorder; service planning; service utilisation