Background
Methods
Setting
Inpatient admission rate
Potential factors associated with geographic variations in inpatient admission rates
Epidemiological factors
Factors related to the supply of health and social care
Supply characteristic | N (%) or mean (SD) |
---|---|
Supply of public mental health care (characteristics of the hospital to which each sector was linked) | |
Public hospitals | 170 (96.59) |
Hospitals specialized in psychiatry | 73 (41.48) |
Hospitals participating to teaching activities | 18 (10.23) |
Hospitals participating to emergency care | 159 (90.34) |
Number of inpatient beds in the hospital (per 100,000 inhabitants) | 29.43 (17.34) |
Supply of private mental health care (per 100,000 inhabitants) | Mean (SD) |
Number of community-based private psychiatrists | 12.75 (9.64) |
Number of psychologists | 70.77 (46.05) |
Number of psychiatric inpatient beds in private for-profit hospitals | 27.74 (22.57) |
Supply of non-specialized health care (per 100,000 inhabitants) | Mean (SD) |
Number of general practitioners | 108.22 (20.24) |
Number of non-psychiatric inpatient beds | 2170.68 (390.46) |
Supply of social care (per 100,000 inhabitants) | Mean (SD) |
Number of beds in housing institutions for disabled individuals | 195.43 (80.46) |
Capacity of centres providing care through employment | 203.20 (63.72) |
Capacity of housing and social rehabilitation centres | 100.64 (41.29) |
Level of urbanization
Analysis
Description of variations
Identification of factors associated with variations in inpatient admission rates
Results
Setting
Characteristics of sectors’ catchment areas
Characteristics of the population
Characteristics of care supply
Variations in inpatient admission rates
Mean (SD) | Median (interquartile range) | Range | CV (%) | Ratio 90/10th percentiles | |
---|---|---|---|---|---|
Inpatient admission rate per 100,000 inhabitants | 77.26 (60.04) | 63.32 (66.49) | 497.20 | 77.71 | 7.65 |
Factors associated with variations in inpatient admission rates
Variable | Estimated value of the coefficient | Standard error | 95% Confidence interval of the coefficient | Exponentiated coefficient | P-value | |
---|---|---|---|---|---|---|
Lower bound | Upper bound | |||||
Intercept | −9.6329 | 0.9758 | −11.5455 | −7.7203 |
< 0.0001
| |
Epidemiological characteristics | ||||||
Psychiatric health status of the population
| ||||||
Number of individuals suffering from chronic mental disorders (per 100,000 inhabitants)a | 0.0000 | 0.0001 | −0.0002 | 0.0003 | 1.0000 | 0.8069 |
Percentage of deaths by suicide among total deaths | 0.0837 | 0.0283 | 0.0282 | 0.1391 | 1.0873 |
0.0031
|
Overall health status of the population (per 100,000 inhabitants) | ||||||
Acute admission rate for somatic disorders | 0.0000 | 0.0000 | −0.0000 | 0.0000 | 1.0000 | 0.2079 |
Mortality rate | 0.0014 | 0.0009 | −0.0004 | 0.0032 | 1.0014 | 0.1223 |
Number of individuals suffering from chronic somaticdisorders | 0.0000 | 0.0000 | −0.0001 | 0.0000 | 1.0000 | 0.1868 |
Demographics of the population
| ||||||
Number of women (per 100,000 inhabitants) | 0.0000 | 0.0000 | −0.0000 | 0.0000 | 1.0000 | 0.9899 |
Mean age of individuals aged over 16 | 0.0166 | 0.0163 | −0.0155 | 0.0486 | 1.0167 | 0.3109 |
Socio-economic characteristics of the population
| ||||||
Quintile of the mean deprivation index (FDep) (from lower to higher deprivation), reference: 5th quintile | ||||||
1 | 0.2679 | 0.1399 | −0.0064 | 0.5422 | 1.3072 | 0.0556 |
2 | 0.2941 | 0.1117 | 0.0751 | 0.5130 | 1.3419 |
0.0085
|
3 | 0.2939 | 0.1102 | 0.0779 | 0.5098 | 1.3416 |
0.0076
|
4 | 0.2944 | 0.1050 | 0.0886 | 0.5002 | 1.3423 |
0.0051
|
Characteristics of the supply of health and social care | ||||||
Supply of public mental health care
| ||||||
Characteristics of the hospital to which each sector was linked
| ||||||
Private non-profit (vs. public) | 0.4939 | 0.1990 | 0.1039 | 0.8840 | 1.6387 |
0.0131
|
Participation to teaching activities (vs. no participation) | −0.3929 | 0.1001 | −0.5891 | −0.1968 | 0.6751 |
< 0.0001
|
Specialization in psychiatry (vs. general hospital) | −0.3476 | 0.0721 | −0.4890 | −0.2062 | 0.7064 |
< 0.0001
|
Participation to emergency care (vs. no participation) | 0.2215 | 0.1068 | 0.0122 | 0.4307 | 1.2479 |
0.0380
|
Number of inpatient beds in the hospital (per 100,000 inhabitants)c | 0.0046 | 0.0025 | −0.0002 | 0.0095 | 1.0046 | 0.0609 |
Supply of private mental health care (per 100,000 inhabitants) | ||||||
Number of community-based private psychiatristsb | −0.0202 | 0.0055 | −0.0310 | −0.0094 | 0.9800 |
0.0003
|
Number of psychologists | 0.0011 | 0.0008 | −0.0005 | 0.0026 | 1.0011 | 0.1678 |
Number of psychiatric inpatient beds in private for-profit hospitalsa | −0.0013 | 0.0020 | −0.0052 | 0.0026 | 0.9987 | 0.5059 |
Supply of non-specialized care (per 100,000 inhabitants) | ||||||
Number of general practitionersb | −0.0009 | 0.0023 | −0.0054 | 0.0035 | 0.9991 | 0.6777 |
Number of non-psychiatric inpatient beds | 0.0001 | 0.0001 | −0.0001 | 0.0002 | 1.0001 | 0.5699 |
Supply of social care (per 100,000 inhabitants) | ||||||
Number of beds in housing institutions for disabled individuals | 0.0012 | 0.0006 | 0.0001 | 0.0023 | 1.0012 |
0.0335
|
Capacity of centres providing care through employment | 0.0003 | 0.0007 | −0.0010 | 0.0017 | 1.0003 | 0.6101 |
Capacity of housing and social rehabilitation centres | −0.0001 | 0.0008 | −0.0017 | 0.0015 | 0.9999 | 0.8884 |
Level of urbanization
| ||||||
Level of urbanization (from lower to higher urbanization), reference: 6th quantile | ||||||
1 | −0.0818 | 0.1147 | −0.3066 | 0.1429 | 0.9215 | 0.4754 |
2 | −0.0664 | 0.1448 | −0.3503 | 0.2174 | 0.9358 | 0.6463 |
3 | −0.0456 | 0.3700 | −0.7709 | 0.6796 | 0.9554 | 0.9018 |
4 | −0.1111 | 0.5310 | −1.1518 | 0.9296 | 0.8948 | 0.8343 |
5 | −0.1557 | 0.1118 | −0.3749 | 0.0634 | 0.8558 | 0.1637 |