Division of Tropical Health and Medicine, College of Medicine and Dentistry, 104397James Cook University, Townsville, QLD, Australia.
Australas Psychiatry. 2023 Feb;31(1):19-26. doi: 10.1177/10398562221139129. Epub 2022 Nov 15.
Estimate impact of socioeconomic factors and remoteness from tertiary hospital on incidence/duration of Australian mental health admissions.
Retrospective analysis of incidence/duration of public mental health unit admissions (2018-19). Covariates included Indigenous population, potentially preventable hospitalisations (PPH) and socioeconomic disadvantage.
Regional distance from hospital was correlated with socioeconomic disadvantage (: < 0.01). Population identifying as Aboriginal or Torres Strait Islander was associated with distance from hospital, socioeconomic disadvantage and PPH (: < 0.01). Bed days per capita was explained (: 0.48) by distance and socioeconomic disadvantage ( < 0.0001). A 1% increase in distance from hospital was associated with a 0.37% decrease in per capita bed days. Admission rate per capita across Queensland and WA was explained (: 0.36) by distance, education/occupation and state ( < 0.05). Across Queensland and WA a 1% increase in distance from hospital was associated with a 0.05% decreased incidence of admission.
Rural Australians face high mental illness burden, socioeconomic disadvantage and limited service provision. Overcoming the additional disadvantages of reduced likelihood of admission to and reduced time in hospital with increasing distance from hospital will require increased outreach proportional to remoteness.
评估社会经济因素和远离三级医院对澳大利亚精神卫生入院的发生率/持续时间的影响。
对 2018-19 年公共精神卫生病房入院的发生率/持续时间进行回顾性分析。协变量包括土著人口、可预防住院治疗(PPH)和社会经济劣势。
与医院的距离与社会经济劣势呈正相关(: < 0.01)。被认定为土著或托雷斯海峡岛民的人口与距离医院、社会经济劣势和 PPH 有关(: < 0.01)。人均床位天数由距离和社会经济劣势解释(: 0.48)( < 0.0001)。距离医院增加 1%,人均床位天数减少 0.37%。昆士兰州和西澳大利亚州的人均入院率由距离、教育/职业和州解释(: 0.36)(< 0.05)。在昆士兰州和西澳大利亚州,距离医院增加 1%,入院率降低 0.05%。
澳大利亚农村地区面临着高精神疾病负担、社会经济劣势和有限的服务提供。要克服因远离医院而入院和住院时间减少的可能性降低的额外劣势,需要根据偏远程度增加相应的外展服务。