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How size matters: exploring the association between quality of mental health services and catchment area size

BACKGROUND: The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities...

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Autores principales: Ala-Nikkola, Taina, Sadeniemi, Minna, Kaila, Minna, Saarni, Samuli, Kontio, Raija, Pirkola, Sami, Joffe, Grigori, Oranta, Olli, Wahlbeck, Kristian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983042/
https://www.ncbi.nlm.nih.gov/pubmed/27520368
http://dx.doi.org/10.1186/s12888-016-0992-5
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author Ala-Nikkola, Taina
Sadeniemi, Minna
Kaila, Minna
Saarni, Samuli
Kontio, Raija
Pirkola, Sami
Joffe, Grigori
Oranta, Olli
Wahlbeck, Kristian
author_facet Ala-Nikkola, Taina
Sadeniemi, Minna
Kaila, Minna
Saarni, Samuli
Kontio, Raija
Pirkola, Sami
Joffe, Grigori
Oranta, Olli
Wahlbeck, Kristian
author_sort Ala-Nikkola, Taina
collection PubMed
description BACKGROUND: The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known. Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others. The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers’ contributions are sensitive to population size. METHODS: To map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors. RESULTS: The diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services. The third sector and public corporations each provided 44 % of the service units. Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units. CONCLUSIONS: Significant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services. Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-016-0992-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-49830422016-08-14 How size matters: exploring the association between quality of mental health services and catchment area size Ala-Nikkola, Taina Sadeniemi, Minna Kaila, Minna Saarni, Samuli Kontio, Raija Pirkola, Sami Joffe, Grigori Oranta, Olli Wahlbeck, Kristian BMC Psychiatry Research Article BACKGROUND: The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known. Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others. The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers’ contributions are sensitive to population size. METHODS: To map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors. RESULTS: The diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services. The third sector and public corporations each provided 44 % of the service units. Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units. CONCLUSIONS: Significant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services. Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-016-0992-5) contains supplementary material, which is available to authorized users. BioMed Central 2016-08-12 /pmc/articles/PMC4983042/ /pubmed/27520368 http://dx.doi.org/10.1186/s12888-016-0992-5 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ala-Nikkola, Taina
Sadeniemi, Minna
Kaila, Minna
Saarni, Samuli
Kontio, Raija
Pirkola, Sami
Joffe, Grigori
Oranta, Olli
Wahlbeck, Kristian
How size matters: exploring the association between quality of mental health services and catchment area size
title How size matters: exploring the association between quality of mental health services and catchment area size
title_full How size matters: exploring the association between quality of mental health services and catchment area size
title_fullStr How size matters: exploring the association between quality of mental health services and catchment area size
title_full_unstemmed How size matters: exploring the association between quality of mental health services and catchment area size
title_short How size matters: exploring the association between quality of mental health services and catchment area size
title_sort how size matters: exploring the association between quality of mental health services and catchment area size
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983042/
https://www.ncbi.nlm.nih.gov/pubmed/27520368
http://dx.doi.org/10.1186/s12888-016-0992-5
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