Healthcare utilization in general practice before and after psychological treatment: a follow-up
data linkage study in primary care
Sammanfattning
Objective. Literature suggests that serious mental health problems increase the use of health
services and psychological interventions can reduce this effect. This study investigates whether this
effect is also found in primary care patients with less serious mental health problems.
Design/setting. Routine electronic health records (EHR) from a representative sample of 128 general
practices were linked to patient files from 150 primary care psychologists participating in the NIVEL
Primary Care Database, using a trusted third party. Data were linked using the date of birth, gender,
and postcode. This yielded 503 unique data pairs that were listed in one of the participating GP
practices in 2008-2010, for people who had psychological treatment from a psychologist that ended in
2009. Main outcome measures. The number of contacts, health problems presented, and prescribed
medication in general practice were analysed before and after the psychological treatment. Results.
Nearly all 503 patients consulted their GP during the six months preceding the psychological
treatment (90.9%) and also in the six months after this treatment had ended (83.7%). The frequency of
contacts was significantly higher before than after the psychological treatment (6.1 vs. 4.8). Fewer
patients contacted their GPs specifically for psychological or social problems (46.3% vs. 38.8%) and
fewer patients had anxiolytic drug prescriptions (15.5% vs. 7.6%) after psychological treatment.
Conclusion. After psychological treatment, patients contact their GPs less often and present fewer
psychological or social problems. Although contact rates seem to decrease, clients of psychologists
are still frequent GP attenders.