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Báo cáo y học: "Supplier-induced demand for psychiatric admissions in Northern New England"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Supplier-induced demand for psychiatric admissions in Northern New England | Watts et al. BMC Psychiatry 2011 11 146 http www.biomedcentral.com 1471-244X 11 146 BMC Psychiatry RESEARCH ARTICLE Open Access Supplier-induced demand for psychiatric admissions in Northern New England 1 1 2 3 Bradley V Watts Brian Shiner Gunnar Klauss and William B Weeks Abstract Background The development of hospital service areas HSAs using small area analysis has been useful in examining variation in medical and surgical care however the techniques of small area analysis are underdeveloped in understanding psychiatric admission rates. We sought to develop these techniques in order to understand the relationship between psychiatric bed supply and admission rates in Northern New England. Our primary hypotheses were that there would be substantial variation in psychiatric admission across geographic settings and that bed availability would be positively correlated with admission rates reflecting a supplier-induced demand phenomenon. Our secondary hypothesis was that the construction of psychiatric HSAs PHSAs would yield more meaningful results than the use of existing general medical hospital service areas. Methods To address our hypotheses we followed a four-step analytic process 1 we used small area analytic techniques to define our PHSAs 2 we calculated the localization index for PHSAs and compared that to the localization index for general medical HSAs 3 we used the number of psychiatric hospital beds the number of psychiatric admissions and census data to calculate population-based bed-supply and psychiatric admission rates for each PHSA and 4 we correlated population-based admission rates to population-based psychiatric bed supply. Results The admission rate for psychiatric diagnosis varied considerably among the PHSAs with rates varying from 2.4 per 100 000 in Portsmouth NH to 13.4 per 100 000 in Augusta ME. There was a positive correlation of 0.71 between a PHSA s supply of beds and admission rate. Using our PSHAs produced a substantially higher .