The use, quality and outcomes of primary health care services in Western Australian mental health clients: a population-based longitudinal study

[Truncated abstract] Background: People with mental illness are at increased risk of physical morbidity and mortality. Emerging evidence indicates that disparities in access to and quality of physical health care may contribute to the poor physical health outcomes in these individuals. Primary care is a foundation of population health, especially for vulnerable groups, including people with mental illness. Understanding the extent of the disparities in use and quality of primary care in people with mental illness is the first step to reducing them. It has also been suggested that regularity and continuity of GP visits, separate from the frequency of GP visits, are associated with better health outcomes in people with chronic diseases. The recent development of the cross-jurisdictional data linkage facility of the Western Australian Data Linkage System (WADLS) links to the WADLS the Australian Commonwealth's Medicare Benefits Scheme (MBS), Pharmaceutical Benefits Scheme (PBS) and aged care data for the entire population of Western Australian. It provides Australian researchers with an unprecedented opportunity to study primary health care services in Australian national health priority areas, and in the case of this thesis, mental health. The specific objectives of this thesis were to: (i) examine the differences in use and indicators of quality of primary health care services in Western Australian mental health clients (MHCs) compared with non-MHCs; and (ii) determine the effects of regularity and continuity of GP visits, separate from the frequency (intensity) of GP visits, on health outcomes (hospitalisation and death) in MHCs.