Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study

Aake Packness, Frans Boch Waldorff, René dePont Christensen, Lene Halling Hastrup, Erik Simonsen, Mogens Vestergaard, Anders Halling

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Abstract

PURPOSE: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.

METHOD: A nationwide register-based cohort study of 50,374 person-years.

RESULTS: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17-1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46-0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77-0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94-0.95) and 1% in the highest (IRR 0.99; CI 0.99-1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85-0.94), whereas rate of visits did not interact.

CONCLUSION: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.

Original languageEnglish
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume52
Issue number11
Pages (from-to)1405–1413
ISSN0933-7954
DOIs
Publication statusPublished - 2017

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socioeconomic position
Mental Health
utilization
mental health
Confidence Intervals
health care
confidence
Outpatients
Odds Ratio
Mental Health Services
human being
contact
psychiatrist
psychologist
health service
low income
Ownership
Comorbidity
comorbidity
Cohort Studies

Cite this

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title = "Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study",
abstract = "PURPOSE: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.METHOD: A nationwide register-based cohort study of 50,374 person-years.RESULTS: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17-1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46-0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77-0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5{\%} in the lowest income group (IRR 0.95; CI 0.94-0.95) and 1{\%} in the highest (IRR 0.99; CI 0.99-1.00). Likewise, contact to psychologists decreased by 11{\%} in the lowest income group (IRR 0.89; CI 0.85-0.94), whereas rate of visits did not interact.CONCLUSION: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.",
author = "Aake Packness and Waldorff, {Frans Boch} and Christensen, {Ren{\'e} dePont} and Hastrup, {Lene Halling} and Erik Simonsen and Mogens Vestergaard and Anders Halling",
year = "2017",
doi = "10.1007/s00127-017-1437-2",
language = "English",
volume = "52",
pages = "1405–1413",
journal = "Social Psychiatry and Psychiatric Epidemiology",
issn = "0933-7954",
publisher = "Springer",
number = "11",

}

Impact of socioeconomic position and distance on mental health care utilization : a nationwide Danish follow-up study. / Packness, Aake; Waldorff, Frans Boch; Christensen, René dePont; Hastrup, Lene Halling; Simonsen, Erik ; Vestergaard, Mogens; Halling, Anders.

In: Social Psychiatry and Psychiatric Epidemiology, Vol. 52, No. 11, 2017, p. 1405–1413.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Impact of socioeconomic position and distance on mental health care utilization

T2 - a nationwide Danish follow-up study

AU - Packness, Aake

AU - Waldorff, Frans Boch

AU - Christensen, René dePont

AU - Hastrup, Lene Halling

AU - Simonsen, Erik

AU - Vestergaard, Mogens

AU - Halling, Anders

PY - 2017

Y1 - 2017

N2 - PURPOSE: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.METHOD: A nationwide register-based cohort study of 50,374 person-years.RESULTS: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17-1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46-0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77-0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94-0.95) and 1% in the highest (IRR 0.99; CI 0.99-1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85-0.94), whereas rate of visits did not interact.CONCLUSION: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.

AB - PURPOSE: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.METHOD: A nationwide register-based cohort study of 50,374 person-years.RESULTS: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17-1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46-0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77-0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94-0.95) and 1% in the highest (IRR 0.99; CI 0.99-1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85-0.94), whereas rate of visits did not interact.CONCLUSION: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.

U2 - 10.1007/s00127-017-1437-2

DO - 10.1007/s00127-017-1437-2

M3 - Journal article

C2 - 28849245

VL - 52

SP - 1405

EP - 1413

JO - Social Psychiatry and Psychiatric Epidemiology

JF - Social Psychiatry and Psychiatric Epidemiology

SN - 0933-7954

IS - 11

ER -