Regional Analysis of Health Service Utilisation by XXXX with Borderline Personality Disorders: Implications for Evidence-Informed Policy.

@entity1 @entity4225 @entity146
BACKGROUND: @entity4225 ( @entity4225 ) has been associated with an intensive use of health resources and a high economic burden. AIMS OF THE STUDY: The aim of this study is to analyze the use of mental healthcare resources by @entity4225 @entity1 , to identify the information gaps on @entity4225 at the regional health databases and to describe specific indicators and patterns of care utilization by @entity1 with @entity4225 in order to guide evidence-informed policy planning in Catalonia (Spain). METHODS: A multi-level cross-design synthesis approach was applied following a mixed quantitative-qualitative analysis to estimate the regional service utilisation of @entity1 with @entity4225 . This framing analysis included estimates based on all available data on the use of services combined with prior expert knowledge gathered through a nominal group of key stakeholders in this field. RESULTS: The estimated year prevalence of @entity4225 was 0.7% but only 9.6% of all @entity4225 @entity1 in Catalonia had any contact with the health care system. Of those, less than half contacted mental health care. @entity4225 represented 1.7% of the total care load in the community mental health centres. A significant information gap was identified in all the official databases and impeded their direct use for planning and resource allocation in @entity4225 . Expert knowledge was required to estimate rates of care utilization at every level of care system (primary care, specialized outpatient care and hospital care). Nevertheless the high pattern of care utilization identified at the databases was accurate according to the experts. DISCUSSION: Detection of @entity4225 was lower than expected in the local, regional and national databases and registries of Catalonia. Local data was judged highly inaccurate by experts in comparison to data available on other @entity146 in the same databases. IMPLICATIONS FOR HEALTH POLICY AND RESEARCH: Specific incentives should be implemented to improve the availability and accuracy of information on @entity4225 at the regional databases. When present, @entity4225 should be coded before other @entity146 in clinical records and health databases. Mental health surveys and @entity146 epidemiological studies should specifically incorporate @entity4225 in their inclusion criteria and further studies on the utilisation pattern of this disorder are needed, both locally and internationally.
