[Relationship Between The Use of Psychosomatic Rehabilitation and Regional Capacities for Medical and Psychotherapeutic Treatment of Mental Disorders in Westphalia].

BACKGROUND

Regional disparities in mental health care are well known and become apparent in inadequate treatment capacities and long waiting time for psychotherapeutic treatment. Hence, the authors assume that there is a shift from curative to rehabilitative care. Accordingly, the purpose of this study was to analyze the relationship between regional treatment capacities and the use of psychosomatic rehabilitation on behalf of the German Statutory Pension Insurance Westphalia (i. e. DRV Westfalen) in 2013.

METHODS

Regional data on medical and psychotherapeutic care within the purview of DRV Westfalen were drawn from public databases. Data on application and approval processes in psychosomatic rehabilitation as well as data on demographic and insurance-related traits, such as periods of insurance, were provided by DRV Westfalen for 2013. Logistic 2-level models were conducted.

RESULTS

Regional data showed that poor medical care was associated with a significantly higher chance of applying for rehabilitation. The demographic and insurance-related traits of the applicants were significantly related both with the application for and approval of psychosomatic rehabilitation. Persons with a discontinuous work biography in 2013 had a higher chance for application for and approval of psychosomatic rehabilitation. No significant correlation of regional treatment capacities and the approval of applications for psychosomatic rehabilitation could be found.

CONCLUSION

The results show that decisions on applications for psychosomatic rehabilitation basically depend on the personal health situation of the applicants. An increased application and approval rate in areas with poor medical care can be interpreted as compensatory means which indicate a need for improvement in regional care of mental disorders.