Banta Jim E, Wiafe Seth, Soret Sam, Holzer Charles
School of Public Health, Loma Linda University, 24951 North Circle Drive, Loma Linda, CA 92350, USA.
J Behav Health Serv Res. 2008 Apr;35(2):179-94. doi: 10.1007/s11414-007-9103-1. Epub 2008 Feb 13.
State and local mental health agencies have responsibility for the psychiatric care of Medicaid beneficiaries and indigents meeting pre-defined criteria. A significant uninsured caseload may prove draining to agencies and hospitals mandated to provide emergency services, resulting in limited access. A spatial needs assessment was conducted to find areas having a greater relative proportion of indigent psychiatric hospitalizations. Robust descriptive and inferential spatial techniques were applied to California 1999-2003 public-use Zip-Code-level hospital discharge data to create maps. These maps reveal a more stable view of spatial variation in the proportion of indigent discharges compared to all psychiatric discharges. Synthetic estimation techniques were also applied to U.S. Census data to estimate the proportion of severe mental illness among households at less than 200% poverty level compared to estimated mental illness among all households. Visually comparing these maps suggests areas of potential mismatch. These results and methods may inform public decision-making.
州和地方心理健康机构负责为符合预先定义标准的医疗补助受益人和贫困人口提供精神科护理。大量未参保病例可能会给被要求提供紧急服务的机构和医院带来负担，导致就医机会受限。进行了一项空间需求评估，以找出贫困精神科住院比例相对较高的地区。运用了强大的描述性和推断性空间技术，对加利福尼亚州1999 - 2003年邮政编码级别的公共医院出院数据进行分析，以绘制地图。与所有精神科出院情况相比，这些地图揭示了贫困出院比例空间变化的更稳定视图。还将综合估计技术应用于美国人口普查数据，以估计贫困水平低于200%的家庭中严重精神疾病的比例，并与所有家庭中估计的精神疾病比例进行比较。通过直观比较这些地图，可以发现潜在不匹配的区域。这些结果和方法可能为公共决策提供参考。
