Health services utilization in patients with eating disorders: evidence from a cohort study in Emilia-Romagna.
OBJECTIVE
To estimate the treated prevalence of eating disorders (ED) in Emilia-Romagna, Italy, and to compare health services utilization among age groups and geographical areas.


METHODS
The study cohort consists of patients aged 12-64 years with a primary or secondary ED diagnosis, treated in regional healthcare facilities in 2012. Patients were followed up for 1 year from the first contact. Data were extracted from regional administrative databases.


RESULTS
The study cohort included 1550 cases, 36.8 % with anorexia nervosa, 21.9 % with bulimia nervosa and 41.3 % with ED not otherwise specified. Adolescents (12-17 years) were 18.6 %, young adults (18-30) 32.7 % and older adults (31-64) 48.7 %. The annual treated prevalence rate was 5.2/10,000 (13.3 for adolescents, 9.3 for young adults and 3.4 for older adults) and was highest among adolescent (24.6/10,000) and young adult females (17.1/10,000). Cases without a record for ED in the previous year were 46.8 %. Older adults displayed higher comorbidity and used more services including hospital-based care. Outpatient care greatly exceeded inpatient care across age groups. Variations in care patterns across regional areas were found.


CONCLUSIONS
Our results indicate that the care pathway for ED varies among age groups and geographical areas, but is consistent with the regional care model that favors the use of outpatient services. Future perspectives include evaluating the integration among mental health services, specialty outpatient units and primary care.
Department of Mental Health and Pathological Addictions, Bologna Local Health Authority, Bologna, Italy.
Antonella
A
Piazza
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, Italy. paola.rucci2@unibo.it.
Paola
P
Rucci
Information System Unit, Health Care and Social Authority, Emilia-Romagna Region, Bologna, Italy.
Massimo
M
Clo
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, Italy.
Dino
D
Gibertoni
Innovation and Organizational Evaluation Service, Modena Local Health Authority, Modena, Italy.
Lucia
L
Camellini
Department of Mental Health and Pathological Addictions, Romagna Local Health Authority, Ravenna, Italy.
Marinella
M
Di Stani
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, Italy.
Maria Pia
MP
Fantini
Outpatient Care Unit, Health Care and Social Authority, Emilia-Romagna Region, Bologna, Italy.
Mila
M
Ferri
Bologna Local Health Authority, Bologna, Italy.
Angelo
A
Fioritti
D000293:Adolescent; D000328:Adult; D002648:Child; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D055815:Young Adult
Anorexia nervosa; Bulimia nervosa; Care pathway; EDNOS; Prevalence
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