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Impact of socioeconomic position and distance on mental health care utilization : a nationwide Danish follow-up study

Packness, Aake; Waldorff, Frans Boch; Christensen, René De Pont; Hastrup, Lene Halling; Simonsen, Erik B.; Vestergaard, Mogens and Halling, Anders LU (2017) In Social Psychiatry and Psychiatric Epidemiology 52(11). p.1405-1413
Abstract

Purpose: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants. Method: A nationwide register-based cohort study of 50,374 person-years. Results: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17–1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46–0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77–0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower... (More)

Purpose: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants. Method: A nationwide register-based cohort study of 50,374 person-years. Results: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17–1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46–0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77–0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94–0.95) and 1% in the highest (IRR 0.99; CI 0.99–1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85–0.94), whereas rate of visits did not interact. Conclusion: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Access to health care, Antidepressants, Geographic information system, Mental health services, Socioeconomic factors
in
Social Psychiatry and Psychiatric Epidemiology
volume
52
issue
11
pages
1405 - 1413
publisher
Steinkopff
external identifiers
  • scopus:85028568295
  • wos:000414158800009
ISSN
0933-7954
DOI
10.1007/s00127-017-1437-2
language
English
LU publication?
yes
id
acbf03ef-cec0-46cf-95cd-25b5433466cc
date added to LUP
2017-10-06 10:17:08
date last changed
2018-01-16 13:21:19
@article{acbf03ef-cec0-46cf-95cd-25b5433466cc,
  abstract     = {<p>Purpose: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants. Method: A nationwide register-based cohort study of 50,374 person-years. Results: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17–1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46–0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77–0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94–0.95) and 1% in the highest (IRR 0.99; CI 0.99–1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85–0.94), whereas rate of visits did not interact. Conclusion: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.</p>},
  author       = {Packness, Aake and Waldorff, Frans Boch and Christensen, René De Pont and Hastrup, Lene Halling and Simonsen, Erik B. and Vestergaard, Mogens and Halling, Anders},
  issn         = {0933-7954},
  keyword      = {Access to health care,Antidepressants,Geographic information system,Mental health services,Socioeconomic factors},
  language     = {eng},
  month        = {08},
  number       = {11},
  pages        = {1405--1413},
  publisher    = {Steinkopff},
  series       = {Social Psychiatry and Psychiatric Epidemiology},
  title        = {Impact of socioeconomic position and distance on mental health care utilization : a nationwide Danish follow-up study},
  url          = {http://dx.doi.org/10.1007/s00127-017-1437-2},
  volume       = {52},
  year         = {2017},
}