A small proportion of patients account for the majority of healthcare usage with 5-15% of patients responsible for 45-70% of costs. Heavy users often suffer from mental and physical illness, particularly an increased level of depression. Physical and sexual abuse, in either childhood or adulthood, is known to be linked to increased levels of depression and a U.S. study of 96 frequent users of health services examined the links between abuse, depression and frequent usage of health services. The researchers found that compared to people who had not been abused people who had suffered abuse over the past year were significantly more likely to be re-admitted to hospital. However, re-admissions were related to chronic disease management and were not the result of the physical effects of abuse. Major depression and abuse interacted with each other to increase rates of re-admission.
Levine, Jeffrey M. ... [et al] - Major depression and recent physical or sexual abuse increase readmissions among high-utilising primary care patients Mental Health in Family Medicine 2008, 5(1), 23-28