Preventable hospitalisation rates increased in mental health patients
MedWire News: Individuals with mental health disorders have significantly higher potentially preventable hospitalisation (PPH) rates than mentally healthy individuals, Australian research shows.
"Health care disparities in vulnerable populations are a public health and ethical challenge," comment Qun Mai (University of Western Australia, Crawley) and team in the journal BMC Psychiatry.
However, they add: "Previous studies have been predominately focused on racial/ethnic, socioeconomic or geographic related disparities, [whereas] mental illness related disparities have been given less attention."
To address this, the team used hospital inpatient discharge data from Western Australia for the period 1990-2006 to analyse PPH rates, as an indicator of the quality of primary care received, among 139,208 mental health patients and 294,180 age- and gender-matched mentally healthy individuals from the electoral roll (controls).
The researchers investigated total PPH rates, and also divided PPHs into four categories; vaccine-preventable, chronic, acute, and adverse drug events (ADEs).
After accounting for age, gender, indigenous status, level of social disadvantage, level of residential remoteness, and physical comorbidities, the team found that mental health patients had significantly higher PPH rates than controls, at an adjusted rate ratio (ARR) of 2.06.
Among mental health patients, PPHs rates were highest for ADEs (ARR=2.66), followed by vaccine-preventable (ARR=2.10), acute (ARR=2.08), and chronic conditions (ARR=1.82).
Regarding specific medical conditions, PPH rates among mental health patients were highest for convulsions and epilepsy (ARR=6.45), nutritional deficiencies (ARR=4.81), chronic obstructive pulmonary disease (ARR=2.64), and asthma (ARR=2.47).
Mental health patients with alcohol and drug disorders, affective disorders, "other" psychoses, and schizophrenia had the highest overall PPH rates, at ARRs of 3.00, 2.58, 2.36, and 2.25, respectively.
Mai and team conclude: "Mental health clients (MHCs) have a significantly higher risk of PPHs than non-MHCs.
"They deserve special attention in research, policy development and clinical practice, with the focus on improving primary and secondary prevention, especially at the primary care level."
By Mark Cowen