To what extent are psychiatrists aware of the comorbid somatic illnesses of their patients with serious mental illnesses? - a cross-sectional secondary data analysis

Somatic comorbidities are a serious problem in patients with severe mental illnesses. These comorbidities often remain undiagnosed for a long time. In Germany, physicians are not allowed to access patients' health insurance data and do not have routine access to documentation from other provide...

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Veröffentlicht in:BMC health services research 2017-02, Vol.17 (1), p.162-162, Article 162
Hauptverfasser: Dornquast, Christina, Tomzik, Juliane, Reinhold, Thomas, Walle, Matthias, Mönter, Norbert, Berghöfer, Anne
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container_start_page 162
container_title BMC health services research
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creator Dornquast, Christina
Tomzik, Juliane
Reinhold, Thomas
Walle, Matthias
Mönter, Norbert
Berghöfer, Anne
description Somatic comorbidities are a serious problem in patients with severe mental illnesses. These comorbidities often remain undiagnosed for a long time. In Germany, physicians are not allowed to access patients' health insurance data and do not have routine access to documentation from other providers of health care. Against this background, the objective of this article was to investigate psychiatrists' knowledge of relevant somatic comorbidities in their patients with severe mental illnesses. Cross-sectional secondary data analysis was performed using primary data from a prospective study evaluating a model of integrated care of patients with serious mental illnesses. The primary data were linked with claims data from health insurers. Patients' diagnoses were derived on the basis of the ICD-10 and the Anatomical Therapeutic Chemical (ATC) classification system. Diabetes, hypertension, coronary artery disease (CAD), hyperlipidaemia, glaucoma, osteoporosis, polyarthritis and chronic obstructive pulmonary disease (COPD) were selected for evaluation. We compared the number of diagnoses reported in the psychiatrists' clinical report forms with those in the health insurance data. The study evaluated records from 1,195 patients with severe mental illnesses. The frequency of documentation of hypertension ranged from 21% in claims data to 4% in psychiatrists' documentation, for COPD from 12 to 0%, respectively, and for diabetes from 7 to 2%, respectively. The percentage of diagnoses deduced from claims data but not documented by psychiatrists ranged from 68% for diabetes and 83% for hypertension, to 90% for CAD to 98% for COPD. The majority of psychiatrists participating in the integrated care programme were insufficiently aware of the somatic comorbidities of their patients. We support allowing physicians to access patients' entire medical records to increase their knowledge of patients' medical histories and, consequently, to increase the safety and quality of care.
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subjects Analysis
Cardiovascular disease
Care and treatment
Chronic obstructive pulmonary disease
Codes
Comorbidity
Coronary vessels
Cross-Sectional Studies
Data analysis
Diabetes
Documentation
Family physicians
Female
Germany - epidemiology
Glaucoma
Health aspects
Health care policy
Health insurance
Health Services Research
Humans
Hypertension
Insurance Claim Review
Insurance, Health - statistics & numerical data
Integrated delivery systems
International Classification of Diseases
Male
Mental disorders
Mental Disorders - epidemiology
Mentally ill
Middle Aged
Osteoporosis
Patients
Physicians
Practice
Prescription drugs
Psychiatrists
Psychiatry
Risk factors
Sensitivity analysis
Somatoform Disorders - diagnosis
Somatoform Disorders - epidemiology
Somatoform Disorders - psychology
Vein & artery diseases
title To what extent are psychiatrists aware of the comorbid somatic illnesses of their patients with serious mental illnesses? - a cross-sectional secondary data analysis
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