Health Service Utilisation, Detection Rates by Family Practitioners, and Management of Patients with Common Mental Disorders in French Family Practice

Overview

Journal Can J Psychiatry

Specialty Psychiatry

Date 2017 Jan 21

PMID 28107037

Citations 1

Authors

Joanna Norton

Agnes Oude Engberink

Catherine Gandubert

Karen Ritchie

Anthony Mann

Michel David

Delphine Capdevielle

Affiliations

Soon will be listed here.

Abstract

Objective: Provide up-to-date detection rates for common mental disorders (CMD) and examine patient service-use since the Preferred Doctor scheme was introduced to France in 2005, with patients encouraged to register with and consult a family practitioner (FP) of their choice.

Methods: Study of 1133 consecutive patients consulting 38 FPs in the Montpellier region, replicating a study performed before the scheme. Patients in the waiting room completed the self-report Patient Health Questionnaire (PHQ) and Client Service-Receipt Inventory with questions on registration with a Preferred Doctor and doctor-shopping. CMD was defined as reaching PHQ criteria for depression, somatoform, panic or anxiety disorder. For each patient, FPs completed a questionnaire capturing psychiatric caseness.

Results: 81.2% of patients were seeing their Preferred Doctor on the survey-day. Of those with a CMD, 52.6% were detected by the FP. This increased with CMD severity and comorbidity. Detected cases were more likely to be consulting their Preferred Doctor (84.7% versus 79.4% for non-detected cases, p = 0.05) rather than another FP. They declared more visits to psychiatrists (17.2% versus 6.7%, p = 0.002). There was no association with consultation frequency or doctor-shopping, which both declined between the two studies.

Conclusion: The CMD detection rate is relatively high, with no increase compared to our previous study, despite a decline in doctor-shopping. An explanation is the same high proportion of patients visiting their usual FP on the survey-day at both periods, suggesting a limited impact of the scheme on care continuity. FP action taken highlights the importance of improving detection for providing care to patients with CMDs.

Citing Articles

Predictors of emergency department and GP use among patients with mental health conditions: a public health survey.

Saini P, McIntyre J, Corcoran R, Daras K, Giebel C, Fuller E Br J Gen Pract. 2019; 70(690):e1-e8.

PMID: 31848197 PMC: 6917360. DOI: 10.3399/bjgp19X707093.

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