This pattern of higher service utilization among female refugees is consistent across regions and countries.
Household size (p = 0.003) was associated with health service use, with a larger size contributing to higher service utilization.
Longitudinally, comorbid internalizing and externalizing problems are associated with higher rates of adult criminality and higher service utilization rates and costs in adulthood [ 16].
Duration of mental disorder [ 24], severity of symptoms [ 15], psychological distress [ 26] and poor physical health [ 23] are other needs-related factors that lead to higher service utilization.
Comorbidity is associated with more severe psychiatric symptoms, more functional disability, longer illness duration, less social competence, and higher service utilization [ 33].
Specific diagnoses tend to lead to much higher service utilization: schizophrenia [ 13], major depression [ 16], anxiety disorders [ 13] and co-occurring mental and substance-use disorders [ 24].
Previous papers report higher service utilization of contracted out PHC facilities due to improved functioning of these facilities and provision of adequate levels of staffing, medicines, supplies and equipment [ 7, 8, 23– 26].
Condom use with clients was associated with power with others (p < .001), while power within was associated with more condom use with regular partners (p < .01) and higher service utilization (p < .05).05
The second part of this proposed intervention derives from a pilot project from our group that applied a culturally focused psychiatric consultation service for a group of high service-utilization patients.
This local seniors' community has a high concentration of older individuals and is an area of high health service utilization.
Consistent with previous reports, we found that high medical service utilization is associated with prevalent mental disorder.
