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Application of mixture distributions for identifying thresholds of frequent and high inpatient mental health service use in longitudinal data

Journal Article


Abstract


  • Background: There is a need for greater understanding about frequent and high use of inpatient mental health services, and those with ongoing increased needs. Most studies employ a threshold of frequent use (e.g. numbers of admissions) and high use (e.g. lengthy stays) without justification. Aims: To identify model-driven thresholds for frequent/high inpatient mental health service use and contrast characteristics of patients identified using various models and thresholds. Method: Retrospective population-based study using 12¬†years of longitudinal data for 5631 patients admitted with a mental health diagnosis. Two-component negative binomial and poisson mixture (truncated/untruncated) models identified thresholds for frequent/high use in a 12-month period. Results: The two-component negative binomial mixture model resulted in the best model fit. Using negative binomial-derived thresholds, 5.3% of patients had a period of frequent use (admitted six or more times), 15.8% of high use (hospitalised for 45 or more days) and 3.5% of heavy use (both frequent and high use). The prevalence of specific mental health disorders (e.g. mood disorder and schizophrenia) among frequent and high use cohorts varied across thresholds. Conclusions: This model-driven approach can be applied to identify thresholds in other cohorts. Threshold choice may depend on the magnitude and focus of potential interventions.

Publication Date


  • 2021

Citation


  • Suesse, B., Lago, L., Westley-Wise, V., Masso, M., Cuenca, J., & Pai, N. (2021). Application of mixture distributions for identifying thresholds of frequent and high inpatient mental health service use in longitudinal data. Journal of Mental Health. doi:10.1080/09638237.2021.1875407

Scopus Eid


  • 2-s2.0-85101187933

Web Of Science Accession Number


Abstract


  • Background: There is a need for greater understanding about frequent and high use of inpatient mental health services, and those with ongoing increased needs. Most studies employ a threshold of frequent use (e.g. numbers of admissions) and high use (e.g. lengthy stays) without justification. Aims: To identify model-driven thresholds for frequent/high inpatient mental health service use and contrast characteristics of patients identified using various models and thresholds. Method: Retrospective population-based study using 12¬†years of longitudinal data for 5631 patients admitted with a mental health diagnosis. Two-component negative binomial and poisson mixture (truncated/untruncated) models identified thresholds for frequent/high use in a 12-month period. Results: The two-component negative binomial mixture model resulted in the best model fit. Using negative binomial-derived thresholds, 5.3% of patients had a period of frequent use (admitted six or more times), 15.8% of high use (hospitalised for 45 or more days) and 3.5% of heavy use (both frequent and high use). The prevalence of specific mental health disorders (e.g. mood disorder and schizophrenia) among frequent and high use cohorts varied across thresholds. Conclusions: This model-driven approach can be applied to identify thresholds in other cohorts. Threshold choice may depend on the magnitude and focus of potential interventions.

Publication Date


  • 2021

Citation


  • Suesse, B., Lago, L., Westley-Wise, V., Masso, M., Cuenca, J., & Pai, N. (2021). Application of mixture distributions for identifying thresholds of frequent and high inpatient mental health service use in longitudinal data. Journal of Mental Health. doi:10.1080/09638237.2021.1875407

Scopus Eid


  • 2-s2.0-85101187933

Web Of Science Accession Number