A nationwide analysis of 350 million patient encounters reveals a high volume of mental-health conditions in primary care

Abstract

How many primary-care encounters are devoted to mental-health conditions compared with physical-health conditions? Here we analyzed Norway’s nationwide administrative primary-care records, extracting all doctor–patient encounters occurring during 14 years (2006–2019) for the population aged 0–100 years. Encounters were recorded according to the International Classification of Primary Care. We compared the volume of mental-health encounters against volumes for conditions in multiple different body systems. A total of 4,875,722 patients generated 354,516,291 encounters. One in 9 encounters (11.7%) involved a mental-health condition. Only musculoskeletal conditions accounted for a greater share of primary-care physicians’ attention. The volume of mental-health encounters in primary care equaled encounters for infections, cardiovascular and respiratory conditions and exceeded encounters for pain, injuries, metabolic, digestive, skin, urological, reproductive and sensory conditions. Primary-care physicians frequently treat complex mental-health conditions in patients of every age. These physicians may have a more important role in preventing the escalation of mental-health problems than heretofore appreciated. The authors present findings of more than 350 million primary-care visits over 14 years in the Norwegian healthcare system, indicating that 1 in 9 encounters involved a mental-health condition and peaking at age 40 years (18.7%).