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在 2015 年至 2021 年期间,荷兰精神保健支出中,年轻人(尤其是年轻女性)所占的比例越来越大。

Young adults, particularly young women, account for an increasingly large share of Dutch mental healthcare expenditure over the period between 2015 and 2021.

机构信息

Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands.

Department of Psychiatry, Yale University, New Haven, CT, USA.

出版信息

Epidemiol Psychiatr Sci. 2024 Oct 11;33:e48. doi: 10.1017/S2045796024000404.

Abstract

AIMS

There is increasing concern over the mental distress of youth in recent years, which may impact mental healthcare utilisation. Here we aim to examine temporal patterns of mental healthcare expenditures in the Netherlands by age and sex in the period between 2015 and 2021.

METHODS

Comprehensive data from health insurers in the Netherlands at the 3-number postal code level were used for cluster weighted linear regressions to examine temporal patterns of mental healthcare expenditure by age group (18-34 vs 35-65). The same was done for medical specialist and general practitioner costs. Additionally, we examined interactions with gender, by adding the interaction between age, year and sex to the model.

RESULTS

Mental healthcare costs for younger adults (18-34) were higher than those for older adults (35-65) at all time points (β = 0.22, 95%-CI = 0.19; 0.25). Furthermore there was an increase in the strength of the association between younger age and mental healthcare costs from β = 0.22 (95%-CI = 0.19; 0.25) in 2015 to β = 0.37 (95%-CI = 0.35; 0.40) in 2021 ( < 0.0001) and this was most evident in women ( < 0.0001). Younger age was associated with lower general practitioner costs at all time points, but this association weakened over time. Younger age was also associated with lower medical specialist costs, which did not weaken over time.

CONCLUSIONS

Young adults, particularly young women, account for an increasing share of mental healthcare expenditure in the Netherlands. This suggests that mental distress in young people is increasingly met by a response from the medical system. To mitigate this trend a public mental health approach is needed.

摘要

目的

近年来,人们越来越关注年轻人的精神困扰,这可能会影响精神卫生保健的利用。在这里,我们旨在研究 2015 年至 2021 年间荷兰按年龄和性别划分的精神保健支出的时间模式。

方法

使用荷兰健康保险公司的 3 位邮政编码级别的综合数据,通过聚类加权线性回归,按年龄组(18-34 岁与 35-65 岁)检查精神保健支出的时间模式。对医学专家和全科医生的费用也进行了同样的研究。此外,我们通过在模型中添加年龄、年份和性别的交互项,检查了与性别的相互作用。

结果

在所有时间点,年轻成年人(18-34 岁)的精神保健费用均高于年长成年人(35-65 岁)(β=0.22,95%-CI=0.19;0.25)。此外,年轻年龄与精神保健费用之间的关联强度从 2015 年的β=0.22(95%-CI=0.19;0.25)增加到 2021 年的β=0.37(95%-CI=0.35;0.40)(<0.0001),这种情况在女性中更为明显(<0.0001)。在所有时间点,年轻年龄与全科医生的费用呈负相关,但这种相关性随着时间的推移而减弱。年轻年龄也与医学专家的费用呈负相关,而且这种相关性不会随着时间的推移而减弱。

结论

年轻成年人,尤其是年轻女性,在荷兰的精神保健支出中所占份额越来越大。这表明年轻人的精神困扰越来越多地得到医疗系统的回应。为了缓解这一趋势,需要采取公共精神卫生方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d2/11561524/84a0acf22276/S2045796024000404_fig1.jpg

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