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Regional Correlates of Psychiatric Inpatient Treatment

Author

Listed:
  • Taina Ala-Nikkola

    (University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, Helsinki FI-00029, Finland
    Unit for Mental Health, National Institute for Health and Welfare (T.H.L.); Mannerheimintie 168, Helsinki FI-00270, Finland
    Public Health Medicine, University of Helsinki and Helsinki University Hospital, Helsinki FI-000014, Finland)

  • Sami Pirkola

    (University of Tampere School of Health Sciences, and Tampere University Hospital, Lääkärinkatu 1, Tampere FI-33014, Finland)

  • Minna Kaila

    (University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, Helsinki FI-00029, Finland
    Public Health Medicine, University of Helsinki and Helsinki University Hospital, Helsinki FI-000014, Finland)

  • Samuli I. Saarni

    (Turku University Hospital and University of Turku, Kiinanmyllynkatu 4-8, Turku FI-20520, Finland)

  • Grigori Joffe

    (University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, Helsinki FI-00029, Finland)

  • Raija Kontio

    (University of Helsinki and Helsinki University Hospital, Välskärinkatu 12, Helsinki FI-00029, Finland
    University of Turku, Turku FI-20014, Finland)

  • Olli Oranta

    (Turku University Hospital and University of Turku, Kiinanmyllynkatu 4-8, Turku FI-20520, Finland)

  • Minna Sadeniemi

    (Unit for Mental Health, National Institute for Health and Welfare (T.H.L.); Mannerheimintie 168, Helsinki FI-00270, Finland
    Department of Social Services and Health Care, City of Helsinki, Helsinki FI-00099, Finland)

  • Kristian Wahlbeck

    (Unit for Mental Health, National Institute for Health and Welfare (T.H.L.); Mannerheimintie 168, Helsinki FI-00270, Finland)

Abstract

Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components.

Suggested Citation

  • Taina Ala-Nikkola & Sami Pirkola & Minna Kaila & Samuli I. Saarni & Grigori Joffe & Raija Kontio & Olli Oranta & Minna Sadeniemi & Kristian Wahlbeck, 2016. "Regional Correlates of Psychiatric Inpatient Treatment," IJERPH, MDPI, vol. 13(12), pages 1-16, December.
    • Handle: RePEc:gam:jijerp:v:13:y:2016:i:12:p:1204-:d:84467
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    References listed on IDEAS

    as
    1. Minna Sadeniemi & Sami Pirkola & Maiju Pankakoski & Grigori Joffe & Raija Kontio & Maili Malin & Taina Ala-Nikkola & Kristian Wahlbeck, 2014. "Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?," IJERPH, MDPI, vol. 11(9), pages 1-12, August.
    2. Pauliina Patana, 2014. "Mental Health Analysis Profiles (MhAPs): Finland," OECD Health Working Papers 72, OECD Publishing.
    3. Taina Ala-Nikkola & Sami Pirkola & Raija Kontio & Grigori Joffe & Maiju Pankakoski & Maili Malin & Minna Sadeniemi & Minna Kaila & Kristian Wahlbeck, 2014. "Size Matters — Determinants of Modern, Community-Oriented Mental Health Services," IJERPH, MDPI, vol. 11(8), pages 1-19, August.
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    Cited by:

    1. Minna Sadeniemi & Nerea Almeda & Jose A. Salinas-Pérez & Mencía R. Gutiérrez-Colosía & Carlos García-Alonso & Taina Ala-Nikkola & Grigori Joffe & Sami Pirkola & Kristian Wahlbeck & Jordi Cid & Luis Sa, 2018. "A Comparison of Mental Health Care Systems in Northern and Southern Europe: A Service Mapping Study," IJERPH, MDPI, vol. 15(6), pages 1-15, May.

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