Small area variation in the utilization of mental health services: implications for health planning and allocation of resources.
OBJECTIVE
To determine the variables associated with utilization of mental health services and to develop a planning model to predict service utilization that incorporates these factors.


METHODS
A regression analysis of service utilization and demographic characteristics was used to assess the relative importance of alternative service, supply of psychiatrists and demographics in explaining variations of services use. A model using socioeconomic factors was applied to the population to predict need.


RESULTS
The percentage of divorced males was the only factor significantly and positively correlated with the utilization of hospital inpatient and provincial psychiatric beds. Predicted need exceeds utilization in 7 out of 10 areas for all services.


CONCLUSIONS
Small area variations in inpatient psychiatric utilization is correlated with community characteristics, not supply of psychiatrists or utilization of alternative services. A model has been developed using census data to allocate resources according to need.
Kelly
A
A
Greater Vancouver Regional Hospital District, Burnaby, British Columbia.
Jones
W
W
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001955:British Columbia / Q000453:epidemiology; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004243:Divorce / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006285:Health Planning / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D017062:Small-Area Analysis; D012959:Socioeconomic Factors; D014600:Utilization Review