Heavy users of psychiatric care -: A review of the state of research

Objective: This paper reviews findings and problems of heavy users research. Methods: The German- and English language literature about,heavy users" and relevant border areas was analyzed. Results: Heavy users are patients who consume a disproportionate share of medical services. The characteristics of heavy users are inhomogeneous. Social problems, denial of illness, noncompliance, comorbid personality disorders and substance misuse contribute significantly to heavy use. Future studies should define heavy use illness-related. More research is needed to clarify whether heavy use of special services is adequate to the patients situation. Conclusions: Heavy users should be identified early, in order to offer them alternative services, which better fulfil the patients specific conditions and prevent an inadequate heavy use of expensive services.