Objectives Collateral in physical wellness of individuals with severe mental disorders is a major public health concern. were linked to the data arranged using unique personal identifiers. Results Patients with severe mental disorders experienced increased probability of hospital care due to coronary heart disease (RR between 1.22 95 CI 1.18 to 1 1.25 and 1.93 1.84 to 2.03 in different age groups) and in 40-49-year-olds also increased probability of revascularisation (1.26 1.16 to 1 1.38) compared with individuals without mental disorders. Access to revascularisation was poorer among older persons with severe mental disorders in relation to need suggested by improved coronary mortality. In spite of excessive coronary mortality (ranging from 0.95 0.89 to 1 1.01 to 3.16 2.82 to 3.54) worst off were people with a history of psychosis who did not have increased use of hospital care and had lower probability of receiving revascularisations (ranging from 0.44 0.37 to 0.51 to 0.74 0.59 to 0.93) compared with individuals without mental disorders. Conclusions Selective mechanisms seem to be at work in access to care and revascularisations among people with severe mental disorders. Healthcare professionals need to be aware of the need for targeted measures to address SNS-032 challenges in provision of somatic care among people with severe mental health problems especially among people with psychoses and old people. SNS-032 Article summary Article focus Equity in physical health of patients with severe mental disorders is a major public health concern since increased morbidity and mortality due to somatic disorders has repeatedly been reported among them. The aim SNS-032 of this cohort study was to examine equity in access to coronary care among persons with a history of severe mental disorder in Finland in 1998 Key messages Our results show poor access to coronary revascularisation according to need among people with severe mental disorders and especially poor access to hospital care and revascularisations among people with psychotic disorders. Healthcare professionals need to be aware of the need for targeted measures to address challenges in provision of somatic care among people with severe mental health problems especially among people with psychoses and old people. Strengths and limitations of this study We used nationwide unselective representative data concerning the total population of Finnish residents in 1998-2009 collected from administrative registers with full coverage and based on clinical diagnoses which allowed us to put the outcomes in proportion to the population SNS-032 at risk. We were able to examine the three major diagnostic groups of severe mental disorders namely mood disorders psychotic disorders and substance abuse disorders. Our data do not enable us to evaluate whether the poor access to care according to need among people with severe mental disorders is due to delay or avoidance in seeking care or poorer responsiveness Rabbit Polyclonal to MAP2K3. of the healthcare system to somatic health problems of these vulnerable patient groups. Introduction Equity in health and equal access to healthcare according to need among vulnerable groups such as people with severe mental disorders is an indicator of well-functioning health systems. Nevertheless increased morbidity and mortality due to somatic disorders including cardiovascular disease respiratory disease and cancer has repeatedly been reported in persons with severe SNS-032 mental disorders compared with the total population.1-8 These findings may derive both from increased incidence and higher case death among patients with mental disorders.9 SNS-032 10 Unhealthier lifestyles poorer socioeconomic circumstances adverse metabolic effects of antipsychotic medications and social consequences of mental illness such as social isolation are likely to explain part of the excess mortality. Another important factor likely to contribute to these differences is poorer access to and quality of healthcare.11 12 Accordingly earlier studies have found elevated coronary heart disease (CHD) mortality but reported no or only slightly elevated use of hospital in- or outpatient care compared with other coronary patients.9 13 Studies have further reported that persons with a history.