Healthcare utilization patterns of individuals with depression after national policy to increase the mental health workforce in primary care: A data linkage study

J.T. Dros*, C.E. van Dijk, K.B.E. Bocker, L.C.J.A.F. Bruins Slot, R.A. Verheij, B.R. Meijboom, J. Dik, I. Bos

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
The deployment of the mental health nurse, an additional healthcare provider for individuals in need of mental healthcare in Dutch general practices, was expected to substitute treatments from general practitioners and providers in basic and specialized mental healthcare (psychologists, psychotherapists, psychiatrists, etc.). The goal of this study was to investigate the extent to which the degree of mental health nurse deployment in general practices is associated with healthcare utilization patterns of individuals with depression.

Methods
We combined national health insurers' claims data with electronic health records from general practices. Healthcare utilization patterns of individuals with depression between 2014 and 2019 (N = 31,873) were analysed. The changes in the proportion of individuals treated after depression onset were assessed in association with the degree of mental health nurse deployment in general practices.

Results
The proportion of individuals with depression treated by the GP, in basic and specialized mental healthcare was lower in individuals in practices with high mental health nurse deployment. While the association between mental health nurse deployment and consultation in basic mental healthcare was smaller for individuals who depleted their deductibles, the association was still significant. Treatment volume of general practitioners was also lower in practices with higher levels of mental health nurse deployment.

Conclusion
Individuals receiving care at a general practice with a higher degree of mental health nurse deployment have lower odds of being treated by mental healthcare providers in other healthcare settings. More research is needed to evaluate to what extent substitution of care from specialized mental healthcare towards general practices might be associated with waiting times for specialized mental healthcare.
Original languageEnglish
Article number158
Number of pages10
JournalBMC Primary Care
Volume25
Issue number1
DOIs
Publication statusPublished - 2024

Keywords

  • Electronic Health Records
  • Health Policy
  • Health System reforms
  • Medical Claims Data
  • Mental Health Nurse
  • Mental Healthcare
  • Routine Healthcare Data
  • Substitution of Care

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