Regional Variation in Supply and Use of Psychiatric Services in 3 Canadian Provinces: Variation régionale de l'offre de services psychiatriques et de leur utilisation dans trois provinces canadiennes.

IF 3.3 3区 医学 Q2 PSYCHIATRY
David Rudoler, Ridhwana Kaoser, M Ruth Lavergne, Sandra Peterson, James M Bolton, Matt Dahl, François Gallant, Kimberley P Good, Myriam Juda, Alan Katz, Jason Morrison, Benoit H Mulsant, Alison L Park, Philip G Tibbo, Juveria Zaheer, Paul Kurdyak
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Abstract

ObjectiveTo examine the patterns in the supply and use of psychiatric services in 3 Canadian provinces: British Columbia, Manitoba, and Ontario.MethodsWe conducted a repeated cross-sectional analysis spanning fiscal years 2012/13 to 2021/22, using patient- and psychiatrist-level data aggregated into administrative health regions. Descriptive statistics and linear regression were used to assess patterns and relationships between the per capita number of psychiatrists ("supply") and measures of use of psychiatric services ("utilization"), including any psychiatrist contact, psychiatric consultation (1-2 visits with the same psychiatrist), and ongoing psychiatric care (3 or more visits with the same psychiatrist).ResultsThe number of psychiatrists per capita remained stable within the 3 provinces during the study period. In 2021/22, Vancouver had the highest number in British Columbia (45 psychiatrists per 100,000 individuals), compared to 14 per 100,000 in lower-supply regions. Toronto had the highest number in Ontario (38 per 100,000), compared to 9 in lower supply regions. Winnipeg had the highest number in Manitoba (25 per 100,000), compared to 7 in the lower supply regions. In 2021/22, the per capita number of psychiatrists was moderately correlated with any psychiatrist contact (R2 = 0.290) and ongoing psychiatric care (R2 = 0.411), but weakly correlated with psychiatric consultation (R2 = 0.005). The relationship between supply and utilization diminishes with higher levels of regional supply.ConclusionsPsychiatrists were unevenly distributed within and across provinces. While more psychiatrists are needed, the moderate and diminishing relationships between their numbers and utilization suggest that increasing this number alone is unlikely to fully address unmet needs for mental healthcare. Strategies to improve access will need to directly target uneven distributions. Further research is needed to understand the factors influencing psychiatrists' practice choices and ways to better support them in increasing their access to care.

加拿大 3 个省精神科服务供应和使用的地区差异。
目的探讨加拿大不列颠哥伦比亚省、马尼托巴省和安大略省精神科服务的供应和使用模式。方法:我们对2012/13至2021/22财政年度的患者和精神科医生数据进行了重复的横断面分析,这些数据汇总到行政卫生区域。使用描述性统计和线性回归来评估人均精神科医生数量(“供应”)与精神科服务使用(“利用”)之间的模式和关系,包括任何精神科医生接触、精神科咨询(1-2次与同一名精神科医生就诊)和持续的精神科护理(3次或以上与同一名精神科医生就诊)。结果三省人均精神科医生数量在研究期间保持稳定。在2021/22年度,温哥华在不列颠哥伦比亚省的精神病医生人数最多(每10万人中有45名精神病医生),而在供应较低的地区,每10万人中有14名精神病医生。多伦多在安大略省的比例最高(每10万人中有38人),而供应较低的地区只有9人。马尼托巴省温尼伯省的人数最多(每10万人中有25人),而供应较低的地区只有7人。2021/22年度,人均精神科医生人数与精神科医生接触次数(R2 = 0.290)和精神科治疗持续度(R2 = 0.411)呈中度相关,与精神科咨询次数呈弱相关(R2 = 0.005)。供应和利用之间的关系随着区域供应水平的提高而减弱。结论省内外精神科医师分布不均匀。虽然需要更多的精神科医生,但他们的人数和使用率之间的适度和递减关系表明,仅增加人数不太可能完全解决精神卫生保健未满足的需求。改善获取的战略需要直接针对不均衡的分配。需要进一步的研究来了解影响精神科医生执业选择的因素,以及更好地支持他们增加获得护理的途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.00
自引率
2.50%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Established in 1956, The Canadian Journal of Psychiatry (The CJP) has been keeping psychiatrists up-to-date on the latest research for nearly 60 years. The CJP provides a forum for psychiatry and mental health professionals to share their findings with researchers and clinicians. The CJP includes peer-reviewed scientific articles analyzing ongoing developments in Canadian and international psychiatry.
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