Outpatient visits for psychiatric disorders in Peru: a nationwide analysis using administrative data

Autores/as

  • Wilmer Cristobal Guzman-Vilca CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru. https://orcid.org/0000-0002-2194-8496
  • Marcia Sanchez-Monge Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado. Lima, Perú.
  • Fritz Fidel Váscones-Román CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru https://orcid.org/0000-0001-9564-0710
  • Rodrigo M. Carrillo-Larco Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. https://orcid.org/0000-0002-2090-1856

DOI:

https://doi.org/10.20453/rnp.v86i4.5183

Palabras clave:

Mental Disorders, Ambulatory Care, Latin America

Resumen

Objective: To quantify the frequency of psychiatric disorders in the outpatient setting in Peru, from 2018 to 2021. Methods: Observational cross-sectional study using outpatient morbidity data from Perú’s National Superintendence of Health. Psychiatric diagnoses were identified using ICD-10 codes. The frequency of major psychiatric disorder groups is described by demographic variables. Monthly trends, as well as the number of outpatient visits per 10,000 population at the subnational level, are also presented. Results: Between 2018-2021, psychiatric disorders accounted for 3,142,685 outpatient visits (2.3% of all) in Peru. Across working age groups, anxiety and depressive disorders comprised approximately 6 out of 10 psychiatric outpatient visits in women, and 4 out of 10 in men. Monthly trends showed two peaks in the absolute number of psychiatric outpatient visits during the pre-pandemic period: April-Mayand September. Provinces in the Highlands had the lowest outpatient visits per 10,000 population. Conclusions: Psychiatric disorders represent a small fraction of the outpatient visits in Peru, with anxiety and depressive disordersas the most frequent. National strategies targeting outpatients with psychiatric disorders should consider demographic differences, monthly trends, and the impact of the COVID-19 pandemic.

Citas

World Health Organization. The WHO special initiative for mental health (2019-2023): universal health coverage for mental health [Internet]. World Health Organization; 2019 [cited 2022 Feb 6]. Report No.: WHO/MSD/19.1. Available from: https://apps. who.int/iris/handle/10665/310981

GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders

in 204 countries and territories, 1990–2019: asystematic analysis for the Global Burden of Disease

Study 2019. The Lancet Psychiatry. 2022 Jan 10;0(0).

Global Burden of Diseases. GBD Results Tool | GHDx [Internet]. [cited 2021 Dec 20]. Available from: http://ghdx.healthdata.org/gbd-results-tool

Pan American Health Organization. Salud Mental [Internet]. [cited 2022 Feb 6]. Available from: https://

www.paho.org/es/temas/salud-mental

United Nations. Goal 3 | Ensure healthy lives and promote well-being for all at all ages [Internet]. [cited

Feb 6]. Available from: https://sdgs.un.org/ goals/goal3

World Health Organization. Number of outpatient visits per person per year [Internet]. The Global Health Observatory. [cited 2022 Feb 6]. Available from: https://www.who.int/data/gho/indicatormetadata-registry/imr-details/3117

Lavergne MR, Shirmaleki M, Loyal JP, Jones W, Nicholls TL, Schütz CG, et al. Emergency department use for mental and substance use disorders: descriptive analysis of population-based, linked administrative

data in British Columbia, Canada. BMJ Open. 2022 Jan 13;12(1):e057072.

Carrillo-Larco RM, Guzman-Vilca WC, LeonVelarde F, Bernabe-Ortiz A, Jimenez MM, Penny ME, et al. Peru – Progress in health and sciences in 200 years of independence. The Lancet Regional Health – Americas. 2022 Mar 1;7.

World Bank. Peru | Data [Internet]. The World Bank | Data. [cited 2022 Feb 7]. Available from: https://data.

worldbank.org/country/PE

Minchan Calderón A, Vásquez León BG, Vásquez Arangoitia CL, Moreno Gutiérrez DL, Ordoñes

Fuentes F de M, Rojas Arteaga NH, et al. Fundamentos de Salud Pública [Internet]. Instituto Nacional de

Salud; 2016 [cited 2021 Dec 27]. Available from: https://repositorio.ins.gob.pe/handle/INS/881

OECD. OECD Reviews of Health Systems: Peru 2017 [Internet]. 2017 [cited 2021 Dec 27]. Available from:

https://www.oecd.org/countries/peru/oecd-reviewsof-health-systems-peru-2017-9789264282735-en. htm

SUSALUD | Superintendencia Nacional de Salud. Consulta B2 - Morbilidad en Consulta Ambulatoria

| SUSALUD Datos Abiertos [Internet]. SUSALUD. [cited 2022 Feb 7]. Available from: http://datos. susalud.gob.pe/dataset/consulta-b2-morbilidad-enconsulta-ambulatoria

Centro Nacional de Planeamiento Estrategico. Información para el planeamiento a nivel departamental, provincial y distrital [Internet]. CEPLAN. [cited 2022 Feb 5]. Available from: https:// www.ceplan.gob.pe/informacion-sobre-zonas-ydepartamentos-del-peru/

Instituto Nacional de Estadistica e Informatica. Censos nacionales 2017: XIII de poblacion, VII de

viviencia y III de comunidades indigenas [Internet]. 2017 [cited 2022 Feb 5]. Available from: https://

censos2017.inei.gob.pe/redatam/

Seo JH, Kim SJ, Lee M, Kang JI. Impact of the COVID-19 pandemic on mental health service use among psychiatric outpatients in a tertiary hospital. J Affect Disord. 2021 Jul 1;290:279–83.

Data for Impact. Number of outpatient department visits per 10,000 population per year [Internet].

[cited 2022 Feb 3]. Available from: https://www. data4impactproject.org/prh/health-systems/healthsystem-strengthening/number-of-outpatientdepartment-visits-per-10000-population-per-year/

Instituto Nacional de Estadistica e Informatica. Estadisticas | Establecimientos del Sector Salud

[Internet]. INEI. [cited 2022 Mar 3]. Available from: https://www.inei.gob.pe/estadisticas/indice-tematico/

health-sector-establishments/

IETSI-EsSalud. Guías de Práctica Clínica [Internet]. [cited 2022 Mar 14]. Available from: http://www.

essalud.gob.pe/ietsi/guias_pract_clini.html

Instituto Nacional de Salud. Guías de Práctica Clínica basadas en Evidencia [Internet]. INSTITUTO

NACIONAL DE SALUD. [cited 2022 Mar 14]. Available from: https://web.ins.gob.pe/es/saludpublica/publicaciones-unagesp/guias-de-practicaclinica

Haque SN. Telehealth Beyond COVID-19. Psychiatr Serv. 2021 Jan 1;72(1):100–3.

Li L, Childs AW. Using a Patient Safety/Quality Improvement Model to Assess Telehealth for

Psychiatry and Behavioral Health Services Among Special Populations During COVID-19 and Beyond. J Psychiatr Pract. 2021 Jul 28;27(4):245–53.

Instituto Nacional de Estadistica e Informatica. Pobreza monetaria alcanzó al 30,1% de la población

del país durante el año 2020 [Internet]. INEI. 2021

[cited 2022 Mar 23]. Available from: https://www. inei.gob.pe/prensa/noticias/pobreza-monetariaalcanzo-al-301-de-la-poblacion-del-pais-durante-elano-2020-12875/

Ministry of Environment of Peru. INEA | Informe Nacional sobre el Estado del Medio Ambiente 2014-

[Internet]. 2021 [cited 2022 Mar 23]. Available from: https://sinia.minam.gob.pe/inea/informe/inicio/

Villarreal-Zegarra D, Cabrera-Alva M, CarrilloLarco RM, Bernabe-Ortiz A. Trends in the prevalence and treatment of depressive symptoms in Peru: a population-based study. BMJ Open. 2020 Jul

;10(7):e036777.

Instituto Nacional de Estadistica e Informatica. Recursos humanos de salud [Internet]. INEI. [cited

Mar 23]. Available from: https://www.inei. gob.pe/estadisticas/indice-tematico/health-humanresources/

Arriola-Vigo JA, Diez-Canseco F. Mental Health Reform in Peru: Innovations, Challenges, and Sustainability. In: Okpaku S, editor. Innovations in Global Mental Health [Internet]. Cham: Springer International Publishing; 2020 [cited 2022 Mar 23]. p. 1–26. Available from: https://doi.org/10.1007/978-

-319-70134-9_93-1

Jake Horton. Covid: Why has Peru been so badly hit? - BBC News [Internet]. BBC. 2021 [cited 2022

Feb 5]. Available from: https://www.bbc.com/news/ world-latin-america-53150808

Ornell F, Borelli WV, Benzano D, Schuch JB, Moura HF, Sordi AO, et al. The next pandemic: impact of

COVID-19 in mental healthcare assistance in a nationwide epidemiological study. Lancet Reg Health

Am. 2021 Dec;4:100061.

Al Garhy M, Al Dhufairi A, Abdulrahman H, Al Maskari B, Ahmed N, Al Khamashi S, et al. Mental

Health Services during the COVID-19 pandemic in Abu Dhabi, UAE. Progress in Neurology and Psychiatry. 2021;25(3):38–41.

Aragona M, Barbato A, Cavani A, Costanzo G, Mirisola C. Negative impacts of COVID-19

lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties. Public Health. 2020 Sep;186:52–6.

Yang J, Landrum MB, Zhou L, Busch AB. Disparities in outpatient visits for mental health and/or substance

use disorders during the COVID surge and partial reopening in Massachusetts. Gen Hosp Psychiatry.

Dec;67:100–6.

Kohn R, Ali AA, Puac-Polanco V, Figueroa C, López-Soto V, Morgan K, et al. Mental health in the

Americas: an overview of the treatment gap. Rev

Panam Salud Publica. 2018;42:e165.

Krüger-Malpartida H, Pedraz-Petrozzi B, ArevaloFlores M, Samalvides-Cuba F, Anculle-Arauco V,

Dancuart-Mendoza M. Effects on Mental Health After the COVID-19 Lockdown Period: Results From a Population Survey Study in Lima, Peru. Clinical Medicine Insights: Psychiatry. 2020 Jan 1;11:1179557320980423.

Saavedra JE, Aliaga-Giraldo K, Castillo-Martell WH, Huamán-Pineda J, Luna-Solis Y, Nicolás-Hoyos

Y, Krüger-Malpartida H, Paz-Schaeffer V, RoblesArana Y, Sagástegui-Soto AA, Sarabia Arce S, VegaDienstmaier JM, Zevallos-Bustamante S. Estudio epidemiológico sobre el impacto de la pandemia COVID-19 en la salud mental de la población de Lima Metropolitana. Diagnóstico (Lima). 2022;61(3):147-186.

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Publicado

2023-12-30

Cómo citar

1.
Guzman-Vilca WC, Sanchez-Monge M, Váscones-Román FF, Carrillo-Larco RM. Outpatient visits for psychiatric disorders in Peru: a nationwide analysis using administrative data. Rev Neuropsiquiatr [Internet]. 30 de diciembre de 2023 [citado 13 de mayo de 2024];86(4):270-8. Disponible en: https://revistas.upch.edu.pe/index.php/RNP/article/view/5183

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