{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T05:49:26Z","timestamp":1778996966292,"version":"3.51.4"},"reference-count":40,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/R024774\/1"],"award-info":[{"award-number":["MR\/R024774\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2023,11]]},"abstract":"\n\t Background<\/jats:title>\n\t People with mental disorders have worse physical health compared with the general population, which could be attributable to receiving poorer quality healthcare.<\/jats:p>\n\t <\/jats:sec>\n\t \n\t Aims<\/jats:title>\n\t To examine the relationship between severe and common mental disorders and risk of emergency hospital admissions for ambulatory care sensitive conditions (ACSCs), and factors associated with increased risk.<\/jats:p>\n\t <\/jats:sec>\n\t \n\t Method<\/jats:title>\n\t Baseline data for England (N<\/jats:italic> = 445 814) were taken from UK Biobank, which recruited participants aged 37\u201373 years during 2006\u20132010, and linked to hospital admission records up to 31 December 2019. Participants were grouped into those with a history of either schizophrenia, bipolar disorder, depression or anxiety, or no mental disorder. Survival analysis was used to assess the risk of hospital admission for ACSCs among those with mental disorders compared with those without, adjusting for factors in different domains (sociodemographic, socioeconomic, health and biomarkers, health-related behaviours, social isolation and psychological).<\/jats:p>\n\t <\/jats:sec>\n\t \n\t Results<\/jats:title>\n\t People with schizophrenia had the highest (unadjusted) risk of hospital admission for ACSCs compared with those with no mental disorder (hazard ratio 4.40, 95% CI 4.04\u20134.80). People with bipolar disorder (hazard ratio 2.48, 95% CI 2.28\u20132.69) and depression or anxiety (hazard ratio 1.76, 95% CI 1.73\u20131.80) also had higher risk. Associations were more conservative when including all admissions, as opposed to first admissions only. The observed associations persisted after adjusting for a range of factors.<\/jats:p>\n\t <\/jats:sec>\n\t \n\t Conclusions<\/jats:title>\n\t People with severe mental disorders have the highest risk of preventable hospital admissions. Ensuring people with mental disorders receive adequate ambulatory care is essential to reduce the large health inequalities they experience.<\/jats:p>\n\t <\/jats:sec>","DOI":"10.1192\/bjo.2023.602","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T09:41:57Z","timestamp":1699350117000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Severe and common mental disorders and risk of emergency hospital admissions for ambulatory care sensitive conditions among the UK Biobank cohort"],"prefix":"10.1192","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6133-4168","authenticated-orcid":false,"given":"Claire L.","family":"Niedzwiedz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Arag\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1864-1861","authenticated-orcid":false,"given":"Josefien J. F.","family":"Breedvelt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2267-1951","authenticated-orcid":false,"given":"Daniel J.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie L.","family":"Prady","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rowena","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"S2056472423006026_ref8","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.puhe.2008.11.001","article-title":"Ambulatory care sensitive conditions: terminology and disease coding need to be more specific to aid policy makers and clinicians","volume":"123","author":"Purdy","year":"2009","journal-title":"Public Health"},{"key":"S2056472423006026_ref15","doi-asserted-by":"crossref","first-page":"e009878","DOI":"10.1136\/bmjopen-2015-009878","article-title":"Depression and risk of hospitalisations and rehospitalisations for ambulatory care-sensitive conditions in Denmark: a population-based cohort study","volume":"5","author":"Davydow","year":"2015","journal-title":"BMJ Open"},{"key":"S2056472423006026_ref14","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1186\/1471-244X-11-163","article-title":"The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study","volume":"11","author":"Mai","year":"2011","journal-title":"BMC Psychiatry"},{"key":"S2056472423006026_ref23","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s12916-019-1305-x","article-title":"Relationship between multimorbidity, demographic factors and mortality: findings from the UK Biobank cohort","volume":"17","author":"Jani","year":"2019","journal-title":"BMC Med"},{"key":"S2056472423006026_ref1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1001\/jamapsychiatry.2014.2502","article-title":"Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis","volume":"72","author":"Walker","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"S2056472423006026_ref11","doi-asserted-by":"crossref","first-page":"j84","DOI":"10.1136\/bmj.j84","article-title":"Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data","volume":"356","author":"Barker","year":"2017","journal-title":"BMJ"},{"key":"S2056472423006026_ref2","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1016\/S0140-6736(19)32316-5","article-title":"A comprehensive analysis of mortality-related health metrics associated with mental disorders: a nationwide, register-based cohort study","volume":"394","author":"Plana-Ripoll","year":"2019","journal-title":"Lancet"},{"key":"S2056472423006026_ref40","author":"Kwint","year":"2023","journal-title":"Supporting the Physical Health of People with Severe Mental Illness"},{"key":"S2056472423006026_ref36","doi-asserted-by":"crossref","first-page":"e023135","DOI":"10.1136\/bmjopen-2018-023135","article-title":"Do care plans and annual reviews of physical health influence unplanned hospital utilisation for people with serious mental illness? Analysis of linked longitudinal primary and secondary healthcare records in England","volume":"8","author":"Ride","year":"2018","journal-title":"BMJ Open"},{"key":"S2056472423006026_ref12","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1177\/070674371105600307","article-title":"Increased risk of avoidable hospitalization among patients with schizophrenia","volume":"56","author":"Lin","year":"2011","journal-title":"Can J Psychiatry"},{"key":"S2056472423006026_ref21","unstructured":"21 UK Biobank. Hospital Inpatient Data. Version 2.0. UK Biobank, 2019."},{"key":"S2056472423006026_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyu222"},{"key":"S2056472423006026_ref33","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-007-0178-z"},{"key":"S2056472423006026_ref6","doi-asserted-by":"crossref","DOI":"10.1097\/MLR.0000000000000448","article-title":"Serious mental illness and risk for hospitalizations and rehospitalizations for ambulatory care-sensitive conditions in Denmark: a nationwide population-based cohort study","volume":"54","author":"Davydow","year":"2016","journal-title":"Med Care"},{"key":"S2056472423006026_ref9","volume-title":"Emergency Hospital Admissions for Ambulatory Care-Sensitive Conditions: Identifying the Potential for Reductions","author":"Tian","year":"2012"},{"key":"S2056472423006026_ref29","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/biomet\/68.2.373","article-title":"On the regression analysis of multivariate failure time data","volume":"68","author":"Prentice","year":"1981","journal-title":"Biometrika"},{"key":"S2056472423006026_ref5","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/S2215-0366(19)30132-4","article-title":"The lancet psychiatry commission: a blueprint for protecting physical health in people with mental illness","volume":"6","author":"Firth","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"S2056472423006026_ref38","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1016\/j.healthpol.2022.10.003","article-title":"Complex community health and social care interventions - which features lead to reductions in hospitalizations for ambulatory care sensitive conditions? a systematic literature review","volume":"126","author":"Duminy","year":"2022","journal-title":"Health Policy"},{"key":"S2056472423006026_ref39","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.genhosppsych.2005.10.006","article-title":"Improving general medical care for persons with mental and addictive disorders: systematic review","volume":"28","author":"Druss","year":"2006","journal-title":"Gen Hosp Psychiatry"},{"key":"S2056472423006026_ref24","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/02701367.2000.11082794","article-title":"Assessment of physical activity: an international perspective","volume":"71","author":"Booth","year":"2000","journal-title":"Res Q Exerc Sport"},{"key":"S2056472423006026_ref3","doi-asserted-by":"crossref","first-page":"e002808","DOI":"10.1136\/bmjopen-2013-002808","article-title":"Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study","volume":"3","author":"Smith","year":"2013","journal-title":"BMJ Open"},{"key":"S2056472423006026_ref17","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.hlpt.2012.07.003","article-title":"UK Biobank: current status and what it means for epidemiology","volume":"1","author":"Allen","year":"2012","journal-title":"Health Policy Technol"},{"key":"S2056472423006026_ref26","first-page":"613","article-title":"An ultra-brief screening scale for anxiety and depression: the PHQ\u20134","volume":"50","author":"Kroenke","year":"2009","journal-title":"Psychosomatics"},{"key":"S2056472423006026_ref22","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1017\/S0047279400020341","article-title":"Deprivation","volume":"16","author":"Townsend","year":"1987","journal-title":"J Soc Policy"},{"key":"S2056472423006026_ref4","doi-asserted-by":"crossref","first-page":"e565","DOI":"10.3399\/BJGP.2020.0884","article-title":"Impact of severe mental illness on healthcare use and health outcomes for people with type 2 diabetes: a longitudinal observational study in England","volume":"71","author":"Han","year":"2021","journal-title":"Br J Gen Pract"},{"key":"S2056472423006026_ref20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020756"},{"key":"S2056472423006026_ref10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002007"},{"key":"S2056472423006026_ref16","doi-asserted-by":"crossref","first-page":"e1001779","DOI":"10.1371\/journal.pmed.1001779","article-title":"UK Biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age","volume":"12","author":"Sudlow","year":"2015","journal-title":"PLoS Med"},{"key":"S2056472423006026_ref31","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1590\/S0102-311X2005000400021","article-title":"Factors associated with readmission to a general hospital in Brazil","volume":"21","author":"Castro","year":"2005","journal-title":"Cad Saude Publica"},{"key":"S2056472423006026_ref35","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-015-0353-3"},{"key":"S2056472423006026_ref18","doi-asserted-by":"crossref","first-page":"e75362","DOI":"10.1371\/journal.pone.0075362","article-title":"Prevalence and characteristics of probable major depression and bipolar disorder within UK Biobank: cross-sectional study of 172,751 participants","volume":"8","author":"Smith","year":"2013","journal-title":"PLoS One"},{"key":"S2056472423006026_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx246"},{"key":"S2056472423006026_ref30","first-page":"61","article-title":"Mental health conditions and hospitalizations for ambulatory care sensitive conditions among veterans with diabetes","volume":"13","author":"Helmer","year":"2020","journal-title":"Am Health Drug Benefits"},{"key":"S2056472423006026_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-016-0147-x"},{"key":"S2056472423006026_ref25","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1192\/bjp.2019.188","article-title":"Understanding cognitive impairment in mood disorders: mediation analyses in the UK Biobank cohort","volume":"215","author":"Cullen","year":"2019","journal-title":"Br J Psychiatry"},{"key":"S2056472423006026_ref13","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1097\/MLR.0b013e31817e188c","article-title":"Mental illness and hospitalization for ambulatory care sensitive medical conditions","volume":"46","author":"Li","year":"2008","journal-title":"Med Care"},{"key":"S2056472423006026_ref37","doi-asserted-by":"publisher","DOI":"10.1186\/s13033-021-00444-4"},{"key":"S2056472423006026_ref19","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0b013e3281c61dc5"},{"key":"S2056472423006026_ref34","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcac119"},{"key":"S2056472423006026_ref7","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s10654-014-9984-2","article-title":"The global impact of non-communicable diseases on healthcare spending and national income: a systematic review","volume":"30","author":"Muka","year":"2015","journal-title":"Eur J Epidemiol"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472423006026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T09:42:19Z","timestamp":1699350139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472423006026\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":40,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["S2056472423006026"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2023.602","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e211"}}