An observational study of socioeconomic disparities in psychiatry consultation uptake in Australia, using routinely collected national data from 2015 to 2022.
Edward Meehan, Thomas Yeatman, Frances Shawyer, Darren Rajit, Vinay Lakra, Graham Meadows, Joanne Enticott
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引用次数: 0
Abstract
Background: The COVID-19 pandemic was associated with increased psychological distress and psychiatric service usage in Australia. Previous research into the first few months of the pandemic found severe inequality in telehealth psychiatry but no change in inequality for psychiatry service usage overall. However, it is unknown how inequality evolved over the remainder of the pandemic, as extended lockdowns continued in major Australian cities.
Aims: To understand how socioeconomic inequality in psychiatric consultations changed during the COVID-19 pandemic, using new data from 2020 to 2022.
Methods: We analysed routinely collected national Medicare data, provided to us as service counts per Statistical Area 3 (SA3) region by financial year from 2015 to 2016 to 2021 to 2022. We calculated daily rates of psychiatry attendances per 100,000 working age adults within each SA3 region, and we evaluated inequality in the distribution of consults using concentration indices and curves based on the Index of Relative Socio-economic Disadvantage (IRSD).
Results: We analysed 7 years of Medicare data from 321 SA3 regions. The national consultation rate increased in 2020 to 2021 from 45.16 to 50.17, and then decreased slightly in 2021 to 22 to 48.65. Inequality as measured by concentration indices rose from 0.169 in 2020 to 2021 to 0.177 in 2021 to 2022. Consultation rates in the most disadvantaged IRSD quintile decreased by 15.9% in 2021 to 2022 compared to smaller decreases of between 1% and 4% in the top 4 quintiles.
Conclusion: Our study shows that inequality in mental health service provision increased in the second year of the COVID-19 pandemic to the highest level seen in the 7 years of data we analysed. Individuals within the most disadvantaged IRSD quintile experienced a significant and disproportionate decline in service rates. Close monitoring and more granular data are needed to understand the drivers behind this inequity and its current status, and to inform interventions to improve it.
期刊介绍：
The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities.
Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas.
The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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