Table 4.
Summary of the evidence for examined predictors of HSU
| Assessments in which variable predicted HSU | Assessments in which variable did not predict HSU | ||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HSU outcomes predicted (n)* | n | HSU outcomes not predicted (n)* | |||||||||||||||||||||||||
| Primary care | Specialist | Inpatient | Total HSU | Primary care | Specialist | Inpatient | Total HSU | ||||||||||||||||||||
| Quality | Quality | Quality | Quality | Quality | Quality | Quality | Quality | ||||||||||||||||||||
| Predictor variables | n variable assessed | n | n | + | − | n | + | − | n | + | − | n | + | − | n | n | + | − | n | + | − | n | + | − | n | + | − |
| Demographic28–37 39 40 42 | |||||||||||||||||||||||||||
| Comorbidity† | 15 | 14 | 4 | 3 | 1 | 3 | 2 | 1 | 3 | 2 | 1 | 4 | 2 | 2 | 1 | 0 | 0 | 1 | 0 | 1 | 0 | ||||||
| Age‡ | 7 | 7 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 1 | 1 | 1 | 1 | 0 | 0 | ||||||||||||
| Female gender | 7 | 5 | 2 | 2 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 0 | 2 | 0 | 0 | 1 | 0 | 1 | 1 | 1 | 0 | ||||||
| Male gender | 7 | 2 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 5 | 2 | 2 | 0 | 2 | 2 | 0 | 1 | 0 | 1 | 0 | ||||||
| NW ethnicity | 6 | 4 | 2 | 2 | 0 | 2 | 2 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 2 | 1 | 1 | ||||||||||
| White ethnicity | 6 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 5 | 2 | 2 | 0 | 2 | 2 | 0 | 0 | 1 | 1 | 0 | ||||||||
| Marital status§ | 5 | 4 | 2 | 2 | 0 | 2 | 2 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | ||||||||||
| Non-home owner | 5 | 2 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 3 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 1 | 0 | 1 | ||||||
| Qualifications | 3 | 0 | 0 | 0 | 0 | 0 | 3 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 1 | 0 | 1 | ||||||||||
| High prev HSU | 2 | 2 | 0 | 0 | 0 | 2 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||||
| Family situation | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 0 | ||||||||||||||
| Occupation | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 1 | 0 | ||||||||||||||
| Total | 65 | 41 | 13 | 12 | 1 | 12 | 11 | 1 | 7 | 5 | 2 | 9 | 6 | 3 | 24 | 6 | 6 | 0 | 6 | 6 | 0 | 5 | 0 | 5 | 7 | 3 | 4 |
| Intervention¶43–53 | |||||||||||||||||||||||||||
| IAPT service | 4 | 4 | 1 | 1 | 0 | 1 | 1 | 0 | 2 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||
| Psychotherapy | 4 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 3 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | ||||||||
| Reminiscence grp | 4 | 0 | 0 | 0 | 0 | 0 | 4 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | ||||||||
| Medication | 3 | 3 | 1 | 1 | 0 | 0 | 2 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||
| Comm outreach | 1 | 1 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||||
| Psychiatric liaison | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||||
| Total | 17 | 10 | 4 | 3 | 1 | 1 | 1 | 0 | 5 | 4 | 1 | 0 | 7 | 1 | 1 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | ||
| Diagnostic26 29 30 39 41 | |||||||||||||||||||||||||||
| PD | 8 | 8 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||
| OCD | 4 | 4 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | ||||||||
| Unspec ICD-10 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||||
| Eating disorder | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | ||||||||||||||
| MADD | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | ||||||||||||||
| Total | 15 | 13 | 4 | 3 | 1 | 3 | 2 | 1 | 3 | 2 | 1 | 3 | 2 | 1 | 2 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | ||||
| Symptoms31–34 38 | |||||||||||||||||||||||||||
| Neurotic | 6 | 6 | 3 | 2 | 1 | 2 | 2 | 0 | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | ||||||||||
| Depression | 4 | 0 | 0 | 0 | 0 | 0 | 4 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | ||||||||
| Positive** | 4 | 0 | 0 | 0 | 0 | 0 | 4 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | ||||||||
| Insomnia | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||||
| Total | 15 | 7 | 4 | 3 | 1 | 2 | 2 | 0 | 0 | 1 | 0 | 1 | 8 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 | ||
| Functioning31 38 | |||||||||||||||||||||||||||
| Social withdrawal | 4 | 0 | 0 | 0 | 0 | 0 | 4 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | ||||||||
| Cognitive deficits | 3 | 3 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||
| ADLs | 2 | 2 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||
| Total | 9 | 5 | 2 | 1 | 1 | 2 | 1 | 1 | 1 | 0 | 1 | 0 | 4 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | ||
| Behavioural35 | |||||||||||||||||||||||||||
| Self-harm | 1 | 1 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||||||||||||
*Most studies examined more than one health service utilisation outcome measure.
†Both mental and physical comorbidity.
‡Various heterogeneous age ranges predicted increased HSU in individual studies: 16–34; 31–49; 45–54; 50–64; >35; 35–54; 75+.
§Only divorced/separated/widowed marital statuses were predictive of increased HSU.
¶If an intervention reduced HSU, it was counted as predicting HSU and vice versa.
**Positive=positive symptoms associated with schizophrenia.
ADLs, activities of daily living; Comm, community; grp, group; HSU, health service utilisation; IAPT, Improving Access to Psychological Therapies initiative; ICD-10, International Classification of Diseases-10; MADD, mixed anxiety and depressive disorder; NW, non-White; PD, personality disorder; prev, previous; Prim, Primary; Unspec, Unspecified +=A score of >16 on STROBE statement,14 or >3 on NICE checklist for RCTs;15 −=A score of <15 on STROBE checklist, or <2 on NICE RCT checklist).