The role of local inpatient psychiatric units and general practitioner on continuity of care in Northern Norway: A case‐register study

Abstract

Objectives:The general practitioners' (GP) role in the care of mental health patients has received increased attention. The literature underlines the need for integration of primary and specialist services, but cross-boundary continuity for patients with severe conditions may be particularly poor. The aim of this study was to analyze the collaboration between primary care and different models of specialized psychiatric services for patients with severe conditions. Methods:We compared a local and a centralized model of mental health care.Service utilization over a 5-year period was studied.Results: Findings suggest that a local institution-based model of services positively affects the use of both GP and specialist outpatient care, with most inpatients utilizing both GP and specialist outpatient consultations. In the centralized model, a substantial proportion of inpatients only used GP outpatient care. Furthermore, inpatients that used both GP and specialist outpatient services received more of both services compared to those who did not enter specialist outpatient care at all. Conclusion:Local inpatient units may positively affect continuity of care and collaboration between general practitioners and specialist psychiatric services compared to more traditional hospital units, probably because better functional integration of services, better facilitation of clinical alliances/relationships, or a more network-oriented treatment philosophy. K E Y W O R D Scontinuity of care, general practitioners, mental health, psychiatry | INTRODUCTIONThe deinstitutionalization of psychiatry has in its essence been a downsizing of central psychiatric institutions in favor of more outpatient-and community-based services (Thornicroft & Bebbington, 1989). The early concept of community psychiatry was very much influenced by the American psychiatrist Alexander Leighton (1982) and his « Bristol Mental Health Center » characterized by rapid and exact diagnostics, pragmatic and systematic research, and identification of local resources and collaborating agencies (Leighton, 1982). In the light of current and broad healthcare reforms, the general practitioners have gradually been given a more important role in such localThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Prevalencia de los trastornos mentales del 2018 al 2020 en Macará y Huaquillas, Ecuador.

“…En otro estudio realizado en adultos mayores a 60 años en España, en donde se encontró que existe mayor número de pacientes con Trastornos neuróticos, secundarios a situaciones estresantes y somatomorfos con un 42.7%, seguido de Trastornos del humor 30.1% y trastornos mentales orgánicos, incluidos los sintomáticos 14.8% (Linares et al, 2008). En un estudio más actual realizado por Myklebust & Lassemo (2021) donde analizaron una muestra de 971 pacientes en Nordland, Noruega encontraron que existe mayor cantidad de pacientes con un diagnóstico en la categoría de trastornos neuróticos, secundarios a situaciones estresantes y somatomorfos F40-49 con un 31.1%, seguido de los trastornos del humor F30-39 con el 30.27%, y en tercer lugar los trastornos mentales y del comportamiento debidos al consumo de sustancias psicótropas F20-29 con el 12.15%. Lo que indica, que en varios estudios los trastornos neuróticos, secundarios a situaciones estresantes y somatomorfos se presentan con más incidencia dentro de las poblaciones.…”

Principales trastornos de ansiedad en dos ciudades de Ecuador

“…En España se realizó un estudio con una muestra de 2054 pacientes mayores a 60 años y descubrieron que la prevalencia de los trastornos ubicados en la categoría F40-49 se situaban en primer lugar con un 42.7% (Linares et al, 2008). De la misma forma, Myklebust & Lassemo (2021) encontraron en su muestra de 917 pacientes provenientes de Nordland-Noruega, que su diagnóstico más frecuente fue el F40-49 con el 31.1% frente a las demás categorías diagnósticas de la CIE-10.…”