gms | German Medical Science

19. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

30.09. - 01.10.2020, digital

Geographic variation in outpatient services and hospital admissions among patients with severe mental illness in Norway

Meeting Abstract

  • Haji Kedir Bedane - Helse Førde HF (Forde Health Trust), Research and Innovation department, Health Atlas section, Førde, Norwegen
  • Marte Bale - Helse Førde HF (Forde Health Trust), Research and Innovation department, Health Atlas section, Førde, Norwegen
  • Maria Holsen - Helse Førde HF (Forde Health Trust), Research and Innovation department, Health Atlas section, Førde, Norwegen
  • Oddne Skrede - Helse Førde HF (Forde Health Trust), Research and Innovation department, Health Atlas section, Førde, Norwegen
  • Knut Ivar Osvoll - Helse Førde HF (Forde Health Trust), Research and Innovation department, Health Atlas section, Førde, Norwegen

19. Deutscher Kongress für Versorgungsforschung (DKVF). sine loco [digital], 30.09.-01.10.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. Doc20dkvf217

doi: 10.3205/20dkvf217, urn:nbn:de:0183-20dkvf2176

Veröffentlicht: 25. September 2020

© 2020 Bedane et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background and current state of (inter)national research: Mental health problems are among the top priorities of public health across the world. Around one billion of the global population are affected by mental and addictive disorders [1]. There is limited evidences on the geographic variation in service utilization among patients with severe mental illness in Norway. The evidence on geographic variation is important to reduce unwarranted variation in health care.

Research questions and objectives: The main aim of this work is to describe variation in use of specialist health care services for patients with severe mental illness among 21 hospital referral areas of Norway.

Methods or hypothesis: We conducted a cross sectional registry based study. We have used data from Norwegian Patient Registry (NPR) from January 1, 2014 to December 31, 2018. We obtained data on the population sizes of the hospital referral areas during the period from Statistics Norway (SSB). Rates were standardized for age and sex by the direct standardization. We have separately analyzed data in two age-based groups, adults 18–64 years and 65 years and older. Variation statistic used in these analysis were extreme quotient (EQ), coefficient of variation (CV) and Systematic Component of Variation (SCV) [2].

Results: For outpatient visits the mean annual number of visits was 308,144 among people aged 18-64 years and 39,000 among people 65 years and older for the country as a whole. The rate of outpatient visits in Lovisenberg hospital referral area was about 6 times higher than what it was for Finnmark hospital referral area among individuals 18–64 years with CV and SCV of 47 and 12, respectively. The rate of outpatient visits among individuals who were 65 years and older varied from 5.8 per 1000 population in Nordland hospital referral area to 147 per 1000 population in Lovisenberg hospital referral area with CV of 112 and SCV of 177.

For hospital admissions, the average annual number of admissions among patients who had severe mental illness was 15,153 for those in the age group 18–64 years, and 1,763 for those aged 65 years and older. The standardized rates of admission among people 18–64 years of age ranged from three per 1,000 population in Diakonhjemmet hospital referral area, to nine per 1,000 population in UNN hospital referral area and CV and SCV were 32 and 12, respectively. The standardized rate of admissions was four times higher for individuals aged 65 and older who resided in Lovisenberg hospital referral area than for those who lived in Nordland hospital referral area with CV of 34 and SCV of 77.

Discussion: The findings of this study indicated that there is considerably high variation both in rates of outpatient visits and in rates of hospital admission among patients with severe mental illness. Further study is needed to examine the determinant factors of variation reported by this study.

Practical implications: Our findings are important in process of reducing unwarranted variation between the geographical areas.


References

1.
Rehm J, Shield KD. Global Burden of Disease and the Impact of Mental and Addictive Disorders. Curr Psychiatry Rep. 2019 Feb;21(2):10. DOI: 10.1007/s11920-019-0997-0 Externer Link
2.
Appleby J, Raleigh V, Frosini F, Bevan G, Gao H, Lyscom T. Variation in healthcare. London: King’s Fund; 2011.