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Preventive service use among people with and without serious mental illnesses

American Journal of Preventive Medicine Oct 23, 2017

Yarborough BJH, et al. - In this study, researchers assessed disparities in preventive care among people with and without serious mental illnesses, believing that this might account for poor health outcomes in people with serious mental illnesses. They found that rates of receipt of preventive services among individuals with serious mental illnesses were equal or better when compared with the general population, in vastly different settings.

Methods

  • Researchers performed this retrospective cohort study on adults (N=803,276) served by Kaiser Permanente Northwest and federally qualified health centers/safety-net community health clinics.
  • All study participants were classified into 5 groups: schizophrenia spectrum disorders, bipolar disorders/affective psychoses, anxiety disorders, nonpsychotic unipolar depression, and reference groups with no evidence of these specific mental illnesses.
  • The primary outcome was overall preventive care-gap rate, the proportion of incomplete preventive services for which each patient was eligible in 2012–2013.
  • Kaiser Permanente Northwest data from 2002 to 2013 was evaluated via secondary analyses.
  • They analyzed data in 2015.

Results

  • Controlling for patient characteristics and health services use, significantly lower Kaiser Permanente Northwest mean care-gap rates were reported for bipolar disorders/affective psychoses (mean=18.6, p<0.001) and depression groups (mean=18.6, p<0.001) compared with the reference group.
  • No difference was seen in schizophrenia (mean=19.4, p=0.236) and anxiety groups (mean=19.9, p=0.060) when compared with the reference group (mean=20.3).
  • Also, data reported that in community health clinics, significantly lower care-gap rates were observed in schizophrenia (mean=34.1, p<0.001), bipolar/affective psychosis (mean=35.7, p<0.001), anxiety (mean=38.5, p<0.001), and depression groups (mean=36.3, p<0.001) as compared with those in the reference group (mean=40.0).
  • In addition, researchers found that secondary analyses of diabetes and dyslipidemia screening trends in Kaiser Permanente Northwest demonstrated diagnostic groups consistently had fewer care gaps than patients in the reference group.

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