TY - JOUR
KW - Adult
KW - Community Mental Health Services
KW - Female
KW - Health Services Accessibility
KW - Hospitalization/statistics & numerical data
KW - Hospitals, Psychiatric/statistics & numerical data
KW - Humans
KW - Male
KW - Mental Disorders/epidemiology/therapy
KW - Portugal/epidemiology
KW - Primary Health Care
KW - Retrospective Studies
KW - Spatial Analysis
KW - Access to healthcare
KW - Clusters
KW - community psychiatry
KW - Join count statistics
KW - primary care
AU - M. Nascimento
AU - B. Lourenço
AU - I. Coelho
AU - J. Aguiar
AU - M. Lázaro
AU - M. Silva
AU - C. Pereira
AU - I. Neves-Caldas
AU - F. Gomes
AU - S. Garcia
AU - S. Nascimento
AU - G. Pereira
AU - V. Nogueira
AU - P. Costa
AU - A. Nobre
A1 - 
AB - BACKGROUND: to understand if patients seen at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) live in geographical clusters or randomly throughout the city, as well as determine their access to the psychiatric hospital and primary care facilities (PCF). METHODS: spatial autocorrelation statistics were performed (queen criterion of contiguity), regarding all patients observed at CHPL in 2017 (at the census subsection level), and considering not only their overall number but also main diagnosis, and admission to the psychiatric ward - voluntary or compulsory. Distance to the hospital and to the closest PCF was measured (for each patient and the variables cited above), and the mean values were compared. Finally, the total number of patients around each PCF was counted, considering specified radius sizes of 656 and 1000 m. RESULTS: All 5161 patients (509 psychiatric admissions) were geolocated, and statistical significance regarding patient clustering was found for the total number (p-0.0001) and specific group of disorders, namely Schizophrenia and related disorders (p-0.007) and depressive disorders (p-0.0002). Patients who were admitted in a psychiatric ward live farther away from the hospital (p-0.002), with the compulsory admissions (versus voluntary ones) living even farther (p-0.004). Furthermore, defining a radius of 1000 m for each PCF allowed the identification of two PCF with more than 1000 patients, and two others with more than 800. CONCLUSIONS: as patients seem to live in geographical clusters (and considering PCFs with the highest number of them), possible locations for the development of programs regarding mental health treatment and prevention can now be identified.
AD - Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal. omaildojoaomiguel@gmail.com.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, Lisbon, Portugal.
BT - BMC health services research
C5 - Healthcare Disparities
CP - 1
DO - 10.1186/s12913-020-05190-w
IS - 1
JF - BMC health services research
LA - eng
M1 - Journal Article
N2 - BACKGROUND: to understand if patients seen at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) live in geographical clusters or randomly throughout the city, as well as determine their access to the psychiatric hospital and primary care facilities (PCF). METHODS: spatial autocorrelation statistics were performed (queen criterion of contiguity), regarding all patients observed at CHPL in 2017 (at the census subsection level), and considering not only their overall number but also main diagnosis, and admission to the psychiatric ward - voluntary or compulsory. Distance to the hospital and to the closest PCF was measured (for each patient and the variables cited above), and the mean values were compared. Finally, the total number of patients around each PCF was counted, considering specified radius sizes of 656 and 1000 m. RESULTS: All 5161 patients (509 psychiatric admissions) were geolocated, and statistical significance regarding patient clustering was found for the total number (p-0.0001) and specific group of disorders, namely Schizophrenia and related disorders (p-0.007) and depressive disorders (p-0.0002). Patients who were admitted in a psychiatric ward live farther away from the hospital (p-0.002), with the compulsory admissions (versus voluntary ones) living even farther (p-0.004). Furthermore, defining a radius of 1000 m for each PCF allowed the identification of two PCF with more than 1000 patients, and two others with more than 800. CONCLUSIONS: as patients seem to live in geographical clusters (and considering PCFs with the highest number of them), possible locations for the development of programs regarding mental health treatment and prevention can now be identified.
PY - 2020
SN - 1472-6963; 1472-6963
SP - 344
T1 - No man is an island: spatial clustering and access to primary care as possible targets for the development of new community mental health approaches
T2 - BMC health services research
TI - No man is an island: spatial clustering and access to primary care as possible targets for the development of new community mental health approaches
U1 - Healthcare Disparities
U2 - 32321489
U3 - 10.1186/s12913-020-05190-w
VL - 20
VO - 1472-6963; 1472-6963
Y1 - 2020
Y2 - Apr 22
ER -