Impact of travel distance on the disposition of patients presenting for emergency psychiatric care.

For veterans presenting for emergency psychiatric care, this research tested the hypothesis that patients with poor geographic accessibility to ambulatory mental health services would be more likely to be hospitalized. Logistic regression results indicated that distant patients (> 60 miles) were 4.8 times more likely (p < .05) to be admitted for acute psychiatric treatment than were proximal patients (< 60 miles), controlling for clinical and demographic case-mix factors. This finding suggests that the Department of Veterans Affairs might be less effective in its effort to substitute intensive outpatient care in place of expensive inpatient treatment for rural veterans with emergent mental health problems.