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dc.contributor.authorO’Neill, Braden
dc.contributor.authorKalia, Sumeet
dc.contributor.authorAliarzadeh, Babak
dc.contributor.authorMoineddin, Rahim
dc.contributor.authorFung, Wai Lun Alan
dc.contributor.authorSullivan, Frank
dc.contributor.authorMaloul, Asmaa
dc.contributor.authorBernard, Steven
dc.contributor.authorGreiver, Michelle
dc.identifier.citationO’Neill , B , Kalia , S , Aliarzadeh , B , Moineddin , R , Fung , W L A , Sullivan , F , Maloul , A , Bernard , S & Greiver , M 2019 , ' Agreement between primary care and hospital diagnosis of schizophrenia and bipolar disorder : a cross-sectional, observational study using record linkage ' , PLoS ONE , vol. 14 , no. 1 , e0210214 .
dc.identifier.otherPURE: 257274058
dc.identifier.otherPURE UUID: 22f86f1a-8ff4-4b03-8683-e940cc4b3393
dc.identifier.otherRIS: urn:A220114DF28379CED4D22D860A1115D2
dc.identifier.otherScopus: 85059623377
dc.identifier.otherWOS: 000455045900053
dc.descriptionFunding: Support for this project was provided by North York General Hospital.en
dc.description.abstractPeople with serious mental illness die 10–25 years sooner than people without these conditions. Multiple challenges to accessing and benefitting from healthcare have been identified amongst this population, including a lack of coordination between mental health services and general health services. It has been identified in other conditions such as diabetes that accurate documentation of diagnosis in the primary care chart is associated with better quality of care. It is suspected that if a patient admitted to the hospital with serious mental illness is then discharged without adequate identification of their diagnosis in the primary care setting, follow up (such as medication management and care coordination) may be more difficult. We identified cohorts of patients with schizophrenia and bipolar disorder who accessed care through the North York Family Health Team (a group of 77 family physicians in Toronto, Canada) and North York General Hospital (a large community hospital) between January 1, 2012 and December 31, 2014. We identified whether labeling for these conditions was concordant between the two settings and explored predictors of concordant labeling. This was a retrospective cross-sectional study using de-identified data from the Health Databank Collaborative, a linked primary care-hospital database. We identified 168 patients with schizophrenia and 370 patients with bipolar disorder. Overall diagnostic concordance between primary care and hospital records was 23.2% for schizophrenia and 15.7% for bipolar disorder. Concordance was higher for those with multiple (2+) inpatient visits (for schizophrenia: OR 2.42; 95% CI 0.64–9.20 and for bipolar disorder: OR 8.38; 95% CI 3.16–22.22). Capture-recapture modeling estimated that 37.4% of patients with schizophrenia (95% CI 20.7–54.1) and 39.6% with bipolar disorder (95% CI 25.7–53.6) had missing labels in both settings when adjusting for patients’ age, sex, income quintiles and co-morbidities. In this sample of patients accessing care at a large family health team and community hospital, concordance of diagnostic information about serious mental illness was low. Interventions should be developed to improve diagnosis and continuity of care across multiple settings.
dc.relation.ispartofPLoS ONEen
dc.rightsCopyright: © 2019 O’Neill et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.titleAgreement between primary care and hospital diagnosis of schizophrenia and bipolar disorder : a cross-sectional, observational study using record linkageen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews.Population and Behavioural Science Divisionen
dc.contributor.institutionUniversity of St Andrews.School of Medicineen
dc.contributor.institutionUniversity of St Andrews.Sir James Mackenzie Institute for Early Diagnosisen
dc.description.statusPeer revieweden

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