A1 Refereed original research article in a scientific journal
Regional Correlates of Psychiatric Inpatient Treatment
Authors: Ala-Nikkola T, Pirkola S, Kaila M, Saarni SI, Joffe G, Kontio R, Oranta O, Sadeniemi M, Wahlbeck K
Publisher: MDPI AG
Publishing place: Basel
Publication year: 2016
Journal: International Journal of Environmental Research and Public Health
Journal name in source: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
Journal acronym: INT J ENV RES PUB HE
Article number: 1204
Volume: 13
Issue: 12
Number of pages: 16
ISSN: 1660-4601
DOI: https://doi.org/10.3390/ijerph13121204
Web address : http://www.mdpi.com/1660-4601/13/12/1204
Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components.
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