Supplier-Induced Demand for Psychiatric Admissions in Northern New England
Author Information
Author(s): Bradley V. Watts, Brian Shiner, Gunnar Klauss, William B. Weeks
Primary Institution: Dartmouth Medical School
Hypothesis
There would be substantial variation in psychiatric admission across geographic settings and that bed availability would be positively correlated with admission rates.
Conclusion
The positive correlation between admission and bed supply suggests that psychiatric bed availability may partially explain the variation in admission rates.
Supporting Evidence
- The admission rate for psychiatric diagnosis varied from 2.4 per 100,000 in Portsmouth, NH to 13.4 per 100,000 in Augusta, ME.
- There was a positive correlation of 0.71 between a PHSA's supply of beds and admission rate.
- Using psychiatric HSAs produced a higher localization index than general medical HSAs (0.69 vs. 0.23).
Takeaway
The number of psychiatric beds available in an area can affect how many people are admitted for psychiatric care, showing that more beds might lead to more admissions.
Methodology
The study used small area analytic techniques to define psychiatric hospital service areas, calculated admission rates, and correlated these with bed supply.
Potential Biases
Potential bias due to reliance on hospitalization data from specific hospitals and exclusion of state psychiatric hospitals.
Limitations
The study did not incorporate measures of quality or outcomes, and it was limited to data from three states.
Participant Demographics
53% of admissions were female; age distribution included 14% aged 18-24, 48% aged 25-44, 22% aged 45-64, 7% aged 65-74, and 11% over 75.
Statistical Information
P-Value
0.0085
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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