Can avilability to psychiatric care explain regional differences in disability pension due to psychiatric disorders?

• Background In previous studies we have found regional differences in rates of sick leave and disability pension (DP) with psychiatric diagnosis. Age and sex composition of the populations could not explain these differences. The aim of this study was to more closely study associations between availability of psychiatric health care staff and regional differences in DP due to psychiatric disorders in Norway. Methods The study base was all individuals 16-67 years in Norway (n = 2 668 827 in 2000) and six southern regions in 1990, 1995, 2000. As indicators of psychiatric health care we used numbers of psychiatrists, psychologists and psychiatric nurses/10 000 and numbers of in-patient beds, hospitalization days and numbers of discharges/10 000 in each region. A multiple linear regression model was used for the statistical analysis. Results Regional differences in disability pension with psychiatric diagnoses remained after controlling for availability to psychiatric care. In two semi rural regions the relative risk increased while it decreased in the capitol Oslo after control for availability for psychiatric care. There was an association between the frequency of DP:s and number of psychiatrists and other physicians (RR 1,49 (95%CI 1,37-1,61), psychologists (RR 1,29 (95% CI 1,23-1,36) and associated nurses (RR 0,84, 95%CI 0,80-0,88). No association was found between DP frequency and number of psychiatric nurses (RR 1,03 95% CI 1,00-1,06). Conclusions Incidence rates of DP with psychiatric diagnoses in different regions were associated with the number of psychiatric health care staff. Possible explanations to found positive associations can be an improved identification of psychiatric cases but future studies are needed regarding the role of professional psychiatric staff in vocational rehabilitation.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Keyword

disability pension

access to health care

psychiatric disorders

Publication and Content Type

vet (subject category)

kon (subject category)