Abstract
Methods
Using a sample of 324 FEP patients from a catchment area-based early intervention (EI) program in Montréal, we estimated the
association of several socio-demographic, clinical, and service-level factors with negative pathways to care and treatment
delay. We also assessed the impact of the pathway to care on time to disengagement from EI services.
association of several socio-demographic, clinical, and service-level factors with negative pathways to care and treatment
delay. We also assessed the impact of the pathway to care on time to disengagement from EI services.
Results
Few socio-demographic or clinical factors were predictive of negative pathways to care. Rather, service-level factors, such
as contact with primary care providers, have a stronger impact on patterns of health service use across multiple indicators.
Patients who were in contact with primary care had a reduced likelihood of negative pathways to care, but also had longer
referral delays to EI services. Socio-demographic and clinical factors were more relevant for predicting subsequent engagement
with EI services, and indicators of negative pathways to care were not associated with service disengagement.
as contact with primary care providers, have a stronger impact on patterns of health service use across multiple indicators.
Patients who were in contact with primary care had a reduced likelihood of negative pathways to care, but also had longer
referral delays to EI services. Socio-demographic and clinical factors were more relevant for predicting subsequent engagement
with EI services, and indicators of negative pathways to care were not associated with service disengagement.
Conclusions
Primary care providers may be an efficacious target for interventions aimed at reducing overall treatment delay. Increasing
the uptake of primary care services may also reduce the likelihood of negative pathways to care. Our findings draw attention
to the need for further investigations of the role that the primary care system plays in early intervention for FEP, and strategies
for supporting service providers in this role.
the uptake of primary care services may also reduce the likelihood of negative pathways to care. Our findings draw attention
to the need for further investigations of the role that the primary care system plays in early intervention for FEP, and strategies
for supporting service providers in this role.
- Content Type Journal Article
- Category Original Paper
- Pages 1-12
- DOI 10.1007/s00127-012-0571-0
- Authors
- Kelly K. Anderson, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC H3A 1A2, Canada
- Rebecca Fuhrer, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC H3A 1A2, Canada
- Norbert Schmitz, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC H3A 1A2, Canada
- Ashok K. Malla, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC H3A 1A2, Canada
- Journal Social Psychiatry and Psychiatric Epidemiology
- Online ISSN 1433-9285
- Print ISSN 0933-7954