scholarly journals Scottish rehabilitation services: their relationship to socio-economic deprivation

1993 ◽  
Vol 17 (6) ◽  
pp. 339-340
Author(s):  
Robin G. McCreadie ◽  
Douglas J. Williamson
Keyword(s):  
Mentally Ill ◽  
Social Deprivation ◽  
Psychiatric Hospitals ◽  
Strong Relationship ◽  
Socioeconomic Deprivation ◽  
Community Resources ◽  
Psychiatric Admission ◽  
Admission Rates ◽  
Catchment Areas ◽  
The Relationship

It is well established that there is a strong relationship between psychiatric admission rates and socioeconomic deprivation; the more deprived the area, the more admissions may be expected (Hirsch, 1988). In the development of community resources for the mentally ill, therefore, an aim might be to site the majority of facilities in areas of greatest social deprivation, as that is where the majority of patients will live. It might also be expected that areas of greater deprivation would have more professional NHS staff. The present survey examines the siting of rehabilitation and support services in the catchment areas of Scottish psychiatric hospitals in relation to measures to socioeconomic deprivation. It also examines the relationship between deprivation and numbers of professional NHS staff in the different catchment areas.

Social indicators and psychiatric admission rates: a case-register study in the Netherlands

1991 ◽  
Vol 21 (1) ◽  
pp. 177-184 ◽  
Author(s):  
Sjoerd Sytema
Keyword(s):  
Relative Risk ◽  
Social Indicators ◽  
The Other ◽  
Logit Models ◽  
Need For Care ◽  
Psychiatric Admission ◽  
Case Register ◽  
Independent Variables ◽  
Admission Rates ◽  
The Relationship

SYNOPSISEnvironmental as well as individual socio-demographic and illness characteristics are related to the risk of admission. This paper addresses the problem of the interrelationships of these factors to admission rates. Using the Groningen Psychiatric Case Register, admission rates (during 1986 and 1987) from 34 administrative areas were calculated. Logit models were fitted in order to test the relationship between the relative risk of being admitted and sex, age, marital status, diagnosis, urbanization and distance from facilities. The effect of urbanization remains under the control of the other independent variables. The concept of ‘need for care’, related to ‘true’ and ‘treated’ incidence, is discussed.

Social Deprivation and Rates of Treated Mental Disorder

1991 ◽  
Vol 158 (4) ◽  
pp. 475-484 ◽  
Author(s):  
Graham Thornicroft
Keyword(s):  
Multiple Regression ◽  
Regression Models ◽  
Social Deprivation ◽  
Psychiatric Morbidity ◽  
Living Alone ◽  
Stepwise Multiple Regression ◽  
Psychiatric Admission ◽  
Admission Rates ◽  
Multiple Regression Models ◽  
High Degree

A review of the literature shows that there are strong associations of treated prevalence rates of psychiatric disorder with social class, sex, marital status, ethnic group and living alone; and moderate associations with living in inner-city areas and a high degree of residential mobility. The Jarman-8 index of social deprivation correlates with psychiatric admission rates for patients aged less than 65 years (R2–0.38). Individual census variables can themselves account for up to 0.71 of the variance in the admission rates, while combined in a stepwise multiple regression the census variables will account for over 0.95 of this variation. Multiple regression models using individual census variables and derived indices should be applied next on a wider geographical basis, and to narrower age, sex and diagnosis-specific psychiatric morbidity rates.

scholarly journals Residential churn moderates the relationship between economic deprivation and psychiatric admission: evidence from Wales

2020 ◽  
pp. jech-2019-213351
Author(s):  
Claire E Handley ◽  
David Oakley ◽  
Christopher W N Saville
Keyword(s):  
Mental Health ◽  
Population Density ◽  
Low Income ◽  
Protective Factor ◽  
Socioeconomic Deprivation ◽  
Economic Deprivation ◽  
Psychiatric Admission ◽  
Admission Rates ◽  
Population Turnover ◽  
The Impact

BackgroundThere is a well-established link between area-level socioeconomic deprivation and psychiatric admission rates. Social capital has been proposed as a possible protective factor that may buffer economically deprived communities, but it may be disrupted in areas with high population turnover. This study aims to test whether population turnover, hereafter called churn, moderates the social gradient of psychiatric admissions.MethodsPopulation churn rates, low income rates and psychiatric admission rates for 1909 lower super output areas in Wales were analysed using Poisson generalised linear mixed-effects models. Additional analyses explored the impact of deprivation measured more generally and the potential confound of population density.ResultsPopulation churn moderated the association between socioeconomic deprivation and psychiatric admission rates, such that greater social gradients in admission rates were found in areas with greater churn. Economic deprivation and churn were also found to be independently positively associated with admission rates. These relationships remained significant when using a broader measure of deprivation and after adjusting for population density.ConclusionHigh churn appears to exacerbate the detrimental effects of economic deprivation on mental health as well as being a risk factor in its own right. Residential stability rates should be considered when designing and implementing policies which aim to understand, prevent and treat mental health problems in at-risk communities.

Excess Mortality Among Elderly Psychiatric In-Patients with Organic Mental Disorder

1995 ◽  
Vol 167 (4) ◽  
pp. 527-532 ◽  
Author(s):  
W. Rössler ◽  
W. Hewer ◽  
B. Fätkenheuer ◽  
W. Löffler
Keyword(s):  
General Population ◽  
Mortality Risk ◽  
Mentally Ill ◽  
Excess Mortality ◽  
Psychiatric Hospitals ◽  
Diagnostic Categories ◽  
Organic Mental Disorder ◽  
Catchment Areas ◽  
Organic Mental Disorders ◽  
Observation Period

BackgroundMany studies have shown hospitalised mentally ill patients to have a higher mortality risk than the general population.MethodData of patients with organic mental disorders of ICD–9 categories 290, 293, 294 and 310 from seven psychiatric hospitals with defined catchment areas were analysed. During an observation period of 2.5 years 1821 treatment periods in these diagnostic categories were recorded.ResultsDuring hospitalisation 137 patients died from natural causes. The age- and sex-adjusted mortality rates show an increased mortality risk of 7.5 times, compared to the general population. The odds ratio of a logistic regression demonstrate the overwhelming influence of the medical diagnosis.ConclusionMedical factors, particularly pneumonias, contribute most to the excess mortality.

Non-linear relationship between an index of social deprivation, psychiatric admission prevalence and the incidence of psychosis

2000 ◽  
Vol 30 (1) ◽  
pp. 177-185 ◽  
Author(s):  
T. J. CROUDACE ◽  
R. KAYNE ◽  
P. B. JONES ◽  
G. L. HARRISON
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Linear Function ◽  
Social Deprivation ◽  
Additive Models ◽  
Psychiatric Services ◽  
Local Regression ◽  
Psychiatric Admission ◽  
The Relationship ◽  
Admission Prevalence

Background. Indicators of population socio-economic disadvantage expressed as weighted deprivation indices show strong relationships with mental health and underpin national funding of psychiatric services. A new index of social deprivation, the Mental Illness Needs Index, has been devised specifically to predict need for psychiatric services. Its validity has not been established outside the area in which it was developed.Methods. We explored the relationship between the Mental Illness Needs Index and two alternative indicators of need for mental health services: the prevalence of psychiatric admission for electoral wards in Nottingham (calculated from Hospital Episode Statistics for the years 1992 and 1993) and ward-based incidence rates for psychosis (ICD-10 F1X-F33). Relationships were explored graphically using local regression models, and estimated using Generalized Linear and Additive Models, and Poisson regression.Results. Social deprivation was strongly related to admission prevalence and psychosis incidence (Spearman's rho 0·63 and 0·44 respectively). Neither admission prevalence, nor the incidence of psychosis were linearly related to social deprivation. Areas with above average social deprivation had both more new cases of psychoses and a higher proportion of the population admitted than expected from a linear function.Conclusions. Application of a linear function to funding gradients may underfund high and low need areas and overfund median need areas. Improving the precision of estimates of the relationship between social deprivation and need for services is crucial to more equitable resource allocation.

Social Deprivation and Psychiatric Admission Rates Among Different Diagnostic Groups

1995 ◽  
Vol 167 (4) ◽  
pp. 456-462 ◽  
Author(s):  
Judy Harrison ◽  
Steve Barrow ◽  
Francis Creed
Keyword(s):  
Psychotic Disorders ◽  
Census Data ◽  
Social Deprivation ◽  
Population Based ◽  
Ethnic Composition ◽  
Psychiatric Admission ◽  
North West ◽  
Admission Rates ◽  
The North ◽  
Positive Correlations

BackgroundIn the search for population-based indicators of need for mental health services, psychiatric admission rates have been correlated with sociodemographic variables. We explored such correlations for different diagnostic groups.MethodAdmissions data for the 19 districts in the North West Region were derived from the Korner Episode System for 1992/3 and divided into eight broad diagnostic groups using ICD–9 codes. Admission rates per 1000 were correlated with measures of deprivation derived from the 1991 census data and with standardised mortality ratios. For the two largest diagnostic groups, correlations with age-standardised admission rates were also calculated.ResultsFor schizophrenia/delusional disorder, eight of the 10 sociodemographic measures were significantly correlated with admission rates (Pearson's r 0.52–0.79). On all measures these correlations were greater than those seen for total mental illness. Significant positive correlations of a lower order were seen for organic brain syndromes and mania. Admission rates for depression, personality disorder and substance misuse were not significantly correlated with any of the sociodemographic measures. Admission rates for neurotic illness were negatively correlated with all deprivation measures, with the negative correlation statistically significant at the 5% level for ethnic composition and overcrowding. Standardising admission rates for age and repeating the analysis after removal of influential data points did not greatly alter these findings.ConclusionsThe association between psychiatric admission rates and measures of deprivation varies considerably with diagnosis. Measures of social deprivation may indicate need for services for patients with psychotic disorders; admission rates for non-psychotic illnesses may reflect the availability of beds rather than need.

Police Admissions to Psychiatric Hospitals: A Challenge to Community Psychiatry?

1987 ◽  
Vol 27 (4) ◽  
pp. 263-268 ◽  
Author(s):  
Thomas A. Fahy ◽  
Donald Bermingham ◽  
John Dunn
Keyword(s):  
Social Worker ◽  
Mentally Ill ◽  
Catchment Area ◽  
Community Psychiatry ◽  
Comparison Group ◽  
Psychiatric Hospitals ◽  
National Average ◽  
Assessment Procedure ◽  
Admission Rates ◽  
Rural Catchment

Compulsory police admissions from an urban and a rural catchment area with admission rates higher than the national average were studied. A comparison was made with a group of patients admitted involuntarily following assessment by a doctor and a social worker. Police admissions differed in several ways from the comparison group and it is suggested that they were less likely to benefit from hospitalization. Taking into account the likelihood of an increase in the number of contacts between the police and the mentally ill, a number of alterations in the assessment procedure are suggested.

scholarly journals Influence of social deprivation on provision of bariatric surgery: 10-year comparative ecological study between two UK specialist centres

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015453 ◽  
Author(s):  
Shivam Bhanderi ◽  
Mushfique Alam ◽  
Jacob Henry Matthews ◽  
Gavin Rudge ◽  
Hamish Noble ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Ecological Study ◽  
Social Deprivation ◽  
Demographic Data ◽  
Socioeconomic Deprivation ◽  
Obesity Prevalence ◽  
Case Volume ◽  
Prevalence Of Obesity ◽  
National Analysis ◽  
The Relationship

ObjectiveTo investigate the effect of residential location and socioeconomic deprivation on the provision of bariatric surgery.DesignRetrospective cross-sectional ecological study.SettingPatients resident local to one of two specialist bariatric units, in different regions of the UK, who received obesity surgery between 2003 and 2013.MethodsDemographic data were collected from prospectively collected databases. Index of Multiple Deprivation (IMD 2010) was used as a measure of socioeconomic status. Obesity prevalences were obtained from Public Health England (2006). Patients were split into three IMD tertiles (high, median, low) and also tertiles of time. A generalised linear model was generated for each time period to investigate the effect of socioeconomic deprivation on the relationship between bariatric case count and prevalence of obesity. We used these to estimate surgical intervention provided in each population in each period at differing levels of deprivation.ResultsData were included from 1163 bariatric cases (centre 1–414, centre 2–749). Incidence rate ratios (IRRs) were calculated to measure the associations between predictor and response variables. Associations were highly non-linear and changed over the 10-year study period. In general, the relationship between surgical case volume and obesity prevalence has weakened over time, with high volumes becoming less associated with prevalence of obesity.DiscussionAs bariatric services have matured, the associations between demand and supply factors have changed. Socioeconomic deprivation is not apparently a barrier to service provision more recently, but the positive relationships between obesity and surgical volume we would expect to find are absent. This suggests that interventions are not being taken up in the areas of need. We recommend a more detailed national analysis of the relationship between supply side and demand side factors in the provision of bariatric surgery.

scholarly journals The Relationship Between Social Deprivation and a Weekend Emergency Medical Admission

2016 ◽  
Vol 15 (3) ◽  
pp. 124-129
Author(s):  
Richard Conway ◽  
◽  
Seán Cournane ◽  
Declan Byrne ◽  
Deirdre O’Riordan ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Poisson Regression ◽  
Small Area ◽  
Social Deprivation ◽  
Specific Effect ◽  
Admission Rate ◽  
Medical Admission ◽  
Admission Rates ◽  
Population Unit ◽  
The Relationship

Background: Deprivation increases admission rates; the specific effect of deprivation with regard to weekend admissions is unknown. Methods: We calculated annual weekend admission rates for each small area population unit and related these to quintiles of Deprivation Index from 2002-2014. Univariate and multivariable risk estimates were calculated using truncated Poisson regression. Results: There were 30,794 weekend admissions in 16,665 patients. The admission rate was substantially higher for more deprived areas, 12.7 per 1000 (95%CI 9.4, 14.7) vs 4.6 per 1000 (95%CI 3.3, 5.8). More deprived patients admitted at the weekend had a significantly lower 30-day in-hospital mortality (10.3% vs 14.5%, p<0.001). Conclusion: Deprivation is a powerful determinant of weekend admissions, however these comprise a group of patients with better outcomes.

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