Primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in Chile
Objectives. To assess the quality of consultation liaison across all primary health care centers in Chile, and its potential relationship with the psychiatric hospitalization rate. Methods. We carried out a countrywide ecological cross-sectional study on 502 primary health centers in 275 municipalit...
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ftdoajarticles:oai:doaj.org/article:870e645dcf49423d97555c6832b80dd4 2023-05-15T15:11:59+02:00 Primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in Chile Rafael Sepúlveda Pedro Zitko Jorge Ramírez Niina Markkula Rubén Alvarado 2018-10-01T00:00:00Z https://doi.org/10.26633/RPSP.2018.138 https://doaj.org/article/870e645dcf49423d97555c6832b80dd4 EN ES PT eng spa por Pan American Health Organization http://iris.paho.org/xmlui/handle/123456789/49514 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 doi:10.26633/RPSP.2018.138 https://doaj.org/article/870e645dcf49423d97555c6832b80dd4 Revista Panamericana de Salud Pública, Vol 42, Pp 1-9 (2018) Referral and consultation hospitals psychiatric community mental health services community psychiatry primary health care Chile Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.26633/RPSP.2018.138 2022-12-31T07:25:48Z Objectives. To assess the quality of consultation liaison across all primary health care centers in Chile, and its potential relationship with the psychiatric hospitalization rate. Methods. We carried out a countrywide ecological cross-sectional study on 502 primary health centers in 275 municipalities (87.3% of total primary health centers in Chile) during 2009. We characterized the presence of consultation liaison using four criteria: availability, frequency, continuity of participants, and continuity across care levels. We also created a dichotomous variable called “optimal consultation liaison” for when all four criteria were met. A quasi-Poisson regression model was used to estimate the rate of hospitalization due to different psychiatric disorders, adjusting by population attributes. Results. Of the primary health centers, 28.3% of them had had optimal consultation liaison during the preceding year, concentrated in the poorest and richest municipalities. Continuity of care was the criterion that was met least often (38.3%). The presence of optimal consultation liaison at the municipal level was associated with fewer psychiatric discharges, with the following incidence rate ratios and 95% confidence intervals (CIs): schizophrenia, 0.65 (95% CI: 0.49–0.85); other psychoses, 0.68 (95% CI: 0.52–0.89); and personality disorders, 0.66 (95% CI: 0. 49–0.89). Municipalities with optimal consultation liaison showed 2.44 fewer total psychiatric discharges per 10 000 inhabitants, although without reaching statistical significance (-0.85 to 5.70). Conclusions. Using a nationally representative sample, we found that consultation liaison in primary care was associated with having fewer psychiatric hospitalizations. More studies are required to understand the role of each component of consultation liaison. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista Panamericana de Salud Pública 42 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English Spanish Portuguese |
topic |
Referral and consultation hospitals psychiatric community mental health services community psychiatry primary health care Chile Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Referral and consultation hospitals psychiatric community mental health services community psychiatry primary health care Chile Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Rafael Sepúlveda Pedro Zitko Jorge Ramírez Niina Markkula Rubén Alvarado Primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in Chile |
topic_facet |
Referral and consultation hospitals psychiatric community mental health services community psychiatry primary health care Chile Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Objectives. To assess the quality of consultation liaison across all primary health care centers in Chile, and its potential relationship with the psychiatric hospitalization rate. Methods. We carried out a countrywide ecological cross-sectional study on 502 primary health centers in 275 municipalities (87.3% of total primary health centers in Chile) during 2009. We characterized the presence of consultation liaison using four criteria: availability, frequency, continuity of participants, and continuity across care levels. We also created a dichotomous variable called “optimal consultation liaison” for when all four criteria were met. A quasi-Poisson regression model was used to estimate the rate of hospitalization due to different psychiatric disorders, adjusting by population attributes. Results. Of the primary health centers, 28.3% of them had had optimal consultation liaison during the preceding year, concentrated in the poorest and richest municipalities. Continuity of care was the criterion that was met least often (38.3%). The presence of optimal consultation liaison at the municipal level was associated with fewer psychiatric discharges, with the following incidence rate ratios and 95% confidence intervals (CIs): schizophrenia, 0.65 (95% CI: 0.49–0.85); other psychoses, 0.68 (95% CI: 0.52–0.89); and personality disorders, 0.66 (95% CI: 0. 49–0.89). Municipalities with optimal consultation liaison showed 2.44 fewer total psychiatric discharges per 10 000 inhabitants, although without reaching statistical significance (-0.85 to 5.70). Conclusions. Using a nationally representative sample, we found that consultation liaison in primary care was associated with having fewer psychiatric hospitalizations. More studies are required to understand the role of each component of consultation liaison. |
format |
Article in Journal/Newspaper |
author |
Rafael Sepúlveda Pedro Zitko Jorge Ramírez Niina Markkula Rubén Alvarado |
author_facet |
Rafael Sepúlveda Pedro Zitko Jorge Ramírez Niina Markkula Rubén Alvarado |
author_sort |
Rafael Sepúlveda |
title |
Primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in Chile |
title_short |
Primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in Chile |
title_full |
Primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in Chile |
title_fullStr |
Primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in Chile |
title_full_unstemmed |
Primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in Chile |
title_sort |
primary care consultation liaison and the rate of psychiatric hospitalizations: a countrywide study in chile |
publisher |
Pan American Health Organization |
publishDate |
2018 |
url |
https://doi.org/10.26633/RPSP.2018.138 https://doaj.org/article/870e645dcf49423d97555c6832b80dd4 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 42, Pp 1-9 (2018) |
op_relation |
http://iris.paho.org/xmlui/handle/123456789/49514 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 doi:10.26633/RPSP.2018.138 https://doaj.org/article/870e645dcf49423d97555c6832b80dd4 |
op_doi |
https://doi.org/10.26633/RPSP.2018.138 |
container_title |
Revista Panamericana de Salud Pública |
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42 |
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1766342745771737088 |