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Prevalence of common mental health disorders in adults who are high or costly users of healthcare services: protocol for a systematic review and meta-analysis
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  • Published on:
    some thoughts about your plans.
    • Frans T Smits, GP dep. of General Practice, University of Amsterdam, the Netherlands

    Dear Ferozkhan,
    I read about your interesting plans to study the prevalence of common mental health disorders in adults who are high or costly users of healthcare services in BMJ Open.
    Please allow me to share with you some thoughts about your plans produced by our own research.
    - We studied the prevalence of (physical, mental and social) problems in the Netherlands (as defined by the GP on the Problem list; ICPC) in (persisting) frequent attenders 1 and whether we could predict, with these GP data, which frequent attender would persist in this behaviour.2
    - We found that high users and costly users are two different groups. Frequent users of primary care3 have higher average/median costs (also and especially in sec care), but high costs are mostly generated in sec care.4
    - We also found that costs are more substantial in persisting frequent users. Perhaps you can consider to differentiate between temporarily and persisting frequent users.
    - Costs are very high in a few outliers. Do you exclude these patients from your research?? Median costs? Average costs?
    - We also found that anxiety, and especially panic disorder, is associated with persistence of frequent attendance in primary care.5
    Much success with your plans!

    Kind regards,
    Frans Smits, GP PhD

    1 Smits FT, Brouwer HJ, Ter Riet G, Van Weert HCP. Epidemiology of frequent attenders: A 3-year historic cohort study comparing attendance, morbidity and pr...

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    Conflict of Interest:
    None declared.