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Estimating Local-Area Needs for Psychiatric Care: A Case Study

Published online by Cambridge University Press:  02 January 2018

Alain D. Lesage*
Affiliation:
Hôpital Louis-H. Lafontaine, Montreal
Doris Clerc
Affiliation:
Hôpital Louis-H. Lafontaine, Montreal
Isabelle Uribé
Affiliation:
Hôpital Louis-H. Lafontaine, Montreal
Jocelyne Cournoyer
Affiliation:
Hôpital Louis-H. Lafontaine, Montreal
José Fabian
Affiliation:
Hôpital Louis-H. Lafontaine, Montreal
Valérie Tourjman
Affiliation:
Hôpital Louis-H. Lafontaine, Montreal
Ian Van Haaster
Affiliation:
Centre de recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montreal
Chi-Hsing Chang
Affiliation:
Unionville, Ontario, Canada
*
Alain D. Lesage, Centre de recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, 7331 Hochelaga, Montréal, Canada HIN 3V2

Abstract

Background

Different approaches to estimating local catchment-area needs for psychiatric services are illustrated and compared.

Method

Data from an epidemiological morbidity survey of a random sample of 496 adults were available, as were actual service utilisation rates. Four types of utilisation were modelled (i.e. overall out-patient, in-patient, emergency clinic) using social indicators available from Statistics Canada census-tract data. Finally, a case–control study compared out-patients from a deprived and an affluent catchment area, matched case by case for primary diagnosis, age, sex and residential status (n=52).

Results

Modelling proved highly predictive of utilisation, the overall-use model accounting for 73% of the variance. The case–control study indicated a higher rate of Axis II traits, substance abuse and needs for social care in the deprived catchment area.

Conclusions

Resource allocation based on the social indicators modelling method was more consistent with sensible distribution of human resources. None of the methods, however, appear to reflect adequately the severity of caseloads evidenced in the case–control study.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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