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Stulz N, Jörg R, Reim-Gautier C, Bonsack C, Conus P, Evans-Lacko S, Gabriel-Felleiter K, Heim E, Jäger M, Knapp M, Richter D, Schneeberger A, Thornicroft SG, Traber R, Wieser S, Tuch A, Hepp U. Mental health service areas in Switzerland. Int J Methods Psychiatr Res 2023; 32:e1937. [PMID: 35976617 PMCID: PMC9976601 DOI: 10.1002/mpr.1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/22/2022] [Accepted: 08/01/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Small area analysis is a health services research technique that facilitates geographical comparison of services supply and utilization rates between health service areas (HSAs). HSAs are functionally relevant regions around medical facilities within which most residents undergo treatment. We aimed to identify HSAs for psychiatric outpatient care (HSA-PSY) in Switzerland. METHODS We used HSAr, a new and automated methodological approach, and comprehensive psychiatric service use data from insurances to identify HSA-PSY based on travel patterns between patients' residences and service sites. Resulting HSA-PSY were compared geographically, demographically and regarding the use of inpatient and outpatient psychiatric services. RESULTS We identified 68 HSA-PSY, which were reviewed and validated by local mental health services experts. The population-based rate of inpatient and outpatient service utilization varied considerably between HSA-PSY. Utilization of inpatient and outpatient services tended to be positively associated across HSA-PSY. CONCLUSIONS Wide variation of service use between HSA-PSY can hardly be fully explained by underlying differences in the prevalence or incidence of disorders. Whether other factors such as the amount of services supply did add to the high variation should be addressed in further studies, for which our functional mapping on a small-scale regional level provides a good analytical framework.
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Affiliation(s)
- Niklaus Stulz
- Integrated Psychiatric Services Winterthur-Zurcher Unterland, Winterthur, Switzerland
| | - Reto Jörg
- Swiss Health Observatory, Neuchatel, Switzerland
| | | | - Charles Bonsack
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Philippe Conus
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | | | - Eva Heim
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | | | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Dirk Richter
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Andres Schneeberger
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Sir Graham Thornicroft
- Centre for Global Mental Health and Center for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rafael Traber
- Organizzazione Sociopsichiatrica Cantonale, Mendrisio, Switzerland
| | - Simon Wieser
- Winterthur Institute of Health Economics, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | | | - Urs Hepp
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Meilener Institute Zurich, Zurich, Switzerland
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