title: Spatial analysis for regional behavior of patients with mental disorders in Japan.
abstract: OBJECTIVE
  The aim of our study was to clarify the geographical movement of patients treated in psychiatric facilities, which can provide important information on the resources and health-care system of psychiatric services.
  
  
  METHODS
  We conducted an analysis of nationwide data on psychiatric patients, collected as an additional survey to the conventional '630 survey' in 2014. For the 151 848 initially admitted inpatients during 6 months and the 144 401 outpatients on a specific day, we identified whether a patient was admitted to a psychiatric facility located in the same medical area as his/her residence. We estimated percentages of being from (i) within the medical area, (ii) within the prefecture, and (iii) outside the prefecture, using a Bayesian statistical approach for each secondary medical area.
  
  
  RESULTS
  The inpatients moved across wider areas than did the outpatients. Almost all inpatients and outpatients received their medical treatment at hospitals/clinics within their prefecture of residence.
  
  
  CONCLUSIONS
  The current mental health medical system in Japan has been operating according to prefecture unit; thus, it may be appropriate to plan a medical system at a prefectural level.
authors.affiliation: Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kunihiko
authors.identifier: http://orcid.org/0000-0003-2387-7772
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Hisateru
authors.initials: H
authors.lastname: Tachimori
authors.affiliation: Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Chiemi
authors.initials: C
authors.lastname: Kan
authors.affiliation: Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nishi
authors.affiliation: Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okumura
authors.affiliation: Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kato
authors.affiliation: Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.|Kawasaki City Mental Health and Welfare Center, Kawasaki, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Takeshima
mesh_terms: D001499:Bayes Theorem; D003710:Demography; D007297:Inpatients; D007564:Japan / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology*; D010045:Outpatients; D062211:Spatio-Temporal Analysis
keywords: inpatients; medical area; outpatients; patients’ behavior; spatial epidemiology