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Social and Mental Health Predictors of Emergency Department and General Practitioner Usage

Saini, P, McIntyre, JC, Corcoran, R, Konstantinos, D, Giebel, C, Fuller, E, Shelton, J, Wilson, T, Comerford, T, Nathan, R and Gabbay, M Social and Mental Health Predictors of Emergency Department and General Practitioner Usage. British Journal of General Practice. ISSN 0960-1643 (Accepted)

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Abstract

Background: High demand for health services is an issue of current importance in England, in part, because of the rapidly increasing use of the Accident and Emergency (A&E) and GP practices for mental health issues and the high cost of these services.
Aim: To examine the social determinants of health service utilisation in people with mental health issues.
Design and Setting: Twenty-eight neighbourhoods (5000 – 10,000 people) on the North West Coast of England, which differed in relative levels of deprivation.
Method: A comprehensive public health survey was conducted, comprising questions on housing, physical health, mental health, lifestyle, social issues, environment, work and finances. Poisson regression models assessed the effect of mental health comorbidity, mental and physical health comorbidity, and individual symptoms on A&E and General Practice (GP) attendances, adjusting for relevant socioeconomic and lifestyle factors.
Results: People who had both a physical and mental health condition reported attending A&E (RR = 4.63, 95%CI 2.86 to 7.51) and GPs (RR = 3.82, 95%CI 3.15, 4.62) more frequently than all other groups. Having a higher number of mental health symptoms was associated with higher GP and A&E service usage. Depression was the strongest symptom predictor of A&E attendance (RR = 1.41, 95%CI 1.05 to 1.90), while anxiety was the strongest symptom predictor of GP attendance, RR = 1.19, 95%CI 1.03 to 1.38.
Conclusion: Mental health comorbidities increase risk of attendances to both A&E and GPs. Further research into the social attributes that contribute to reduced A&E and GP attendance rates is required.

Item Type: Article
Uncontrolled Keywords: 1117 Public Health and Health Services
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Natural Sciences & Psychology (closed 31 Aug 19)
Publisher: Royal College of General Practitioners
Date Deposited: 24 Jul 2019 15:01
Last Modified: 24 Jul 2019 15:01
URI: http://researchonline.ljmu.ac.uk/id/eprint/11109

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