Potrebny Thomas, Wiium Nora, Haugstvedt Anne, Sollesnes Ragnhild, Wold Bente, Thuen Frode
Centre for Evidence-Based Practice, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway.
BMC Health Serv Res. 2021 Feb 3;21(1):115. doi: 10.1186/s12913-021-06124-w.
Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need.
This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time.
We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16 and 66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend.
Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.
北欧年轻人的心理困扰正在增加。根据既定的医疗保健利用理论，这将导致对青少年初级医疗保健的需求增加，进而促使心理困扰的年轻人更多地寻求帮助。本研究的目的是调查在心理健康问题增加和服务需求上升时期，青少年初级医疗保健服务的使用与心理困扰之间的关联。
本研究包含从2014年至2018年期间居住在挪威的13至19岁年轻人（n = 368,579）收集的五轮年度重复横断面数据。采用对数链接的人口加权和设计调整广义线性回归来研究青少年初级医疗保健服务随时间的使用情况。
我们发现很大一部分年轻人使用初级医疗保健服务，心理困扰程度高的年轻人使用初级医疗保健服务的频率是心理困扰程度低的同龄人的两倍。此外，2014年至2018年期间，心理困扰和初级医疗保健服务利用率均有所上升：心理困扰增加了5%，每1000名年轻人的初级医疗保健服务总使用量增加了500次就诊。总体而言，心理困扰与青少年初级医疗保健服务的使用存在条件关联，根据服务类型的不同，其可解释2014年至2018年期间服务使用变化的16%至66%。然而，初级医疗保健服务使用量的绝对增加主要是由心理困扰程度低的年轻人推动的，而非心理困扰程度高的年轻人。这表明存在一种趋同趋势。
我们的研究结果表明，心理困扰程度高的年轻人在需求和寻求帮助行为之间可能存在严重障碍，而心理困扰程度较低的年轻人的使用模式可能表明存在过度使用的情况，这可能是新出台的学校缺勤政策无意中导致的结果。虽然需要进一步研究来证实这些发现，但我们的工作可为医疗保健提供者和政策制定者提供有关年轻人初级医疗保健利用趋势的信息。
