Modeling socio-demographic and clinical factors influencing psychiatric inpatient service use: a comparison of models for zero-Inflated and overdispersed count data
| Autor: | Gene Marcoux, Sharmin Sharker, Lloyd Balbuena, Cindy Feng |
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| Rok vydání: | 2020 |
| Předmět: |
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medicine.medical_specialty Adolescent Epidemiology Socio demographics Health Informatics Primary care Disease Odds Hurdle models Model diagnosis 03 medical and health sciences 0302 clinical medicine Zero-inflated models Health care Humans Medicine 030212 general & internal medicine Psychiatry Inpatient service Demography lcsh:R5-920 Inpatients 030505 public health Primary Health Care business.industry Mental Disorders Repeated hospitalizations Model comparison Mental health Hospitalization lcsh:Medicine (General) 0305 other medical science business Research Article Count data |
| Zdroj: | BMC Medical Research Methodology, Vol 20, Iss 1, Pp 1-10 (2020) BMC Medical Research Methodology |
| ISSN: | 1471-2288 |
| Popis: | Background Psychiatric disorders may occur as a single episode or be persistent and relapsing, sometimes leading to suicidal behaviours. The exact causes of psychiatric disorders are hard to determine but easy access to health care services can help to reduce their severity. The aim of this study was to investigate the factors associated with repeated hospitalizations among the patients with psychiatric illness, which may help the policy makers to target the high-risk groups in a more focused manner. Methods A large linked administrative database consisting of 200,537 patients with psychiatric diagnosis in the years of 2008-2012 was used in this analysis. Various counts regression models including zero-inflated and hurdle models were considered for analyzing the hospitalization rate among patients with psychiatric disorders within three months follow-up since their index visit dates. The covariates for this study consisted of socio-demographic and clinical characteristics of the patients. Results The results show that the odds of hospitalization are significantly higher among registered Indians, male patients and younger patients. Hospitalization rate depends on the patients’ disease types. Having previously visited a general physician served a protective role for psychiatric hospitalization during the study period. Patients who had seen an outpatient psychiatrist were more likely to have a higher number of psychiatric hospitalizations. This may indicate that psychiatrists tend to see patients with more severe illnesses, who require hospital-based care for managing their illness. Conclusions Providing easier access to registered Indian people and youth may reduce the need for hospital-based care. Patients with mental health conditions may benefit from greater and more timely access to primary care. |
| Databáze: | OpenAIRE |
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