ArticleBMC health services research2018
Geographic variations in involuntary care and associations with the supply of health and social care: results from a nationwide study.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Measurement Properties of the Staff Attitude to Coercion Scale: A Systematic Review.Frontiers in psychiatry · 2022Pooled it
- Psychiatric advance directives facilitated by peer workers among people with mental illness: economic evaluation of a randomized controlled trial (DAiP study).Epidemiology and psychiatric sciences · 2023Trial
- Reducing ethnic inequalities in experiences and outcomes of mental illness: A realist informed national programme evaluation.PLOS mental health · 2026Article
- Variation in Psychiatric Hospitalisations: A Multiple-Membership Multiple-Classification Analysis.International journal of environmental research and public health · 2024Article
- Factors associated with involuntary mental healthcare in New South Wales, Australia.BJPsych open · 2024Article
- Long term outcomes and causal modelling of compulsory inpatient and outpatient mental health care using Norwegian registry data: Protocol for a controversies in psychiatry research project.International journal of methods in psychiatric research · 2023Article
- The relationship between area levels of involuntary psychiatric care and patient outcomes: a longitudinal national register study from Norway.BMC psychiatry · 2023Article
- Geographical variation in compulsory hospitalisation - ethical challenges.BMC health services research · 2022Article
- Factors in Psychiatric Admissions: Before and During the Covid-19 Pandemic.Clinical neuropsychiatry · 2021Article
- Measuring the level of compulsory hospitalisation in mental health care: The performance of different measures across areas and over time.International journal of methods in psychiatric research · 2021Article
- Service Characteristics and Geographical Variation in Compulsory Hospitalisation: An Exploratory Random Effects Within-Between Analysis of Norwegian Municipalities, 2015-2018.Frontiers in psychiatry · 2021Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundInvoluntary psychiatric care remains controversial. Geographic disparities in its use can challenge the appropriateness of the care provided when they do not result from different health needs of the population. These disparities should be reduced through dedicated health policies. However, their association with the supply of health and social care, which could be targeted by such policies, has been insufficiently studied. Our objectives were therefore to describe geographic variations in involuntary admission rates across France and to identify the characteristics of the supply of care which were associated with these variations.
methodsInvoluntary admission rate per 100,000 adult inhabitants was calculated in French psychiatric sectors' catchment areas using 2012 data from the national psychiatric discharge database. Its variations were first described numerically and graphically. Several factors potentially associated with these variations were then considered in a negative binomial regression with an offset term accounting for the size of catchment areas. They included characteristics of the supply of care (public and private care, health and social care, hospital and community-based care, specialised and non-specialised care) as well as adjustment factors related to epidemiological characteristics of the population of each sector's catchment area and its level of urbanization. Such variables were extracted from complementary administrative databases. Supply characteristics associated with geographic variations were identified using a significance level of 0.05.
resultsSignificant variations in involuntary admission rates were observed between psychiatric sectors' catchment areas with a coefficient of variation close to 80%. These variations were associated with some characteristics of the supply of health and social care in the sectors' catchment areas. Notably, an increase in the availability of community-based private psychiatrists and the capacity of housing institutions for disabled individuals was associated with a decrease in involuntary admission rates while an increase in the availability of general practitioners was associated with an increase in those rates.
conclusionsThere is evidence of considerable variations in involuntary admission rates between psychiatric sectors' catchment areas. Our results provide lines of thoughts to reduce such variations, in particular by supporting an increase in the availability of upstream and downstream care in the community.
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