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. 2017 Nov;52(11):1405-1413.
doi: 10.1007/s00127-017-1437-2. Epub 2017 Aug 28.

Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study

Aake Packness  1 , Frans Boch Waldorff  2 , René dePont Christensen  2 , Lene Halling Hastrup  3 , Erik Simonsen  3   4 , Mogens Vestergaard  5 , Anders Halling  6
Affiliations

Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study

Aake Packness et al. Soc Psychiatry Psychiatr Epidemiol. 2017 Nov.

Erratum in

Abstract

Purpose: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.

Method: A nationwide register-based cohort study of 50,374 person-years.

Results: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17-1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46-0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77-0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94-0.95) and 1% in the highest (IRR 0.99; CI 0.99-1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85-0.94), whereas rate of visits did not interact.

Conclusion: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.

Keywords: Access to health care; Antidepressants; Geographic information system; Mental health services; Socioeconomic factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

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