Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study

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Abstract

Purpose: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants. Method: A nationwide register-based cohort study of 50,374 person-years. Results: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17–1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46–0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77–0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94–0.95) and 1% in the highest (IRR 0.99; CI 0.99–1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85–0.94), whereas rate of visits did not interact. Conclusion: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.

Detaljer

Författare
  • Aake Packness
  • Frans Boch Waldorff
  • René De Pont Christensen
  • Lene Halling Hastrup
  • Erik B. Simonsen
  • Mogens Vestergaard
  • Anders Halling
Enheter & grupper
Externa organisationer
  • University of Southern Denmark
  • University of Copenhagen
  • Aarhus University
  • Region Sjælland
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

Nyckelord

Originalspråkengelska
Sidor (från-till)1405-1413
TidskriftSocial Psychiatry and Psychiatric Epidemiology
Volym52
Utgåva nummer11
Tidigt onlinedatum2017 aug 28
StatusPublished - 2017
PublikationskategoriForskning
Peer review utfördJa