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Psychiatr Prax 2024; 51(05): 270-276
DOI: 10.1055/a-2265-8375
Originalarbeit

Wie gemeindenah soll Psychiatrie sein? Distanzeffekte auf die Inanspruchnahme psychiatrischer Leistungen in einer Schweizerischen Versorgungsregion

Distance Decay Effects in a Swiss Mental Health Services System
Niklaus Stulz 
1   Ärztliche Direktion, Integrierte Psychiatrie Winterthur-Zürcher Unterland, Winterthur, Schweiz
,
Benjamin Dubno
1   Ärztliche Direktion, Integrierte Psychiatrie Winterthur-Zürcher Unterland, Winterthur, Schweiz
,
Ralf Gebhardt
2   Spitaldirektion, Psychiatrische Dienste Thurgau, Münsterlingen, Schweiz
,
Urs Hepp
3   Klinik für Konsiliarpsychiatrie und Psychosomatik, Universitätsspital Zürich, Schweiz
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Zusammenfassung

Ziel der Studie Untersuchung der psychiatrischen Inanspruchnahme in Abhängigkeit von der Anreisezeit zu den Behandlungsangeboten.

Methodik Retrospektive Analyse der Inanspruchnahmekohorte 2022 (18–64 Jahre alt) in einem psychiatrischen Dienst in der Schweiz.

Ergebnisse Die bevölkerungsbezogenen ambulanten Inanspruchnahmeraten nahmen mit zunehmender Distanz (Reisezeit im öffentlichen Verkehr) zwischen den Wohngemeinden und den zuständigen Ambulatorien deutlich und statistisch signifikant ab. Für die stationäre Inanspruchnahme fanden sich deutlich geringere Distanzeffekte.

Schlussfolgerung In einem gut zugänglichen und ökonomisch vernünftigen psychiatrischen Versorgungssystem sollten stationäre und spezialisierte Angebote zentral organisiert werden, während ambulante, allgemeinpsychiatrische Angebote eher dezentral und wohnortsnah zu planen sind.

Abstract

Objective To investigate psychiatric service use depending on distances (travel times) to inpatient and outpatient service sites.

Methods Retrospective cohort analysis of all patients aged 18–64 years who had been treated in a Swiss psychiatric services system in 2022.

Results Outpatient service utilization rates decreased statistically significantly with increasing distance (travel time by public transportation) between the place of residence and the responsible outpatient clinic. For inpatient utilization, the distance decay effects were much less strong and did not always reach a statistically significant level.

Conclusion In an easily accessible and economically reasonable psychiatric services system, inpatient and specialized services should be organized centrally, while general outpatient psychiatric services should be planned decentralized and close to the communities where people live.

Schlüsselwörter

Psychiatrische Versorgung - Gemeindenahe Versorgung - Distanzeffekte - Geographie

Keywords

Mental health - Community Health Services - Distance - Geography


Publication History

Received: 06 November 2023

Accepted: 09 February 2024

Article published online:
29 March 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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