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Geographical variation in mental hospital discharges in Greece and socioeconomic correlates: a nationwide study
M G Madianos1, C Zacharakis, C Tsitsa
1Department of Psychiatry, School of Health Sciences, Faculty of Nursing, University of Athens, Athens, Greece.
Background:
In this paper the geographical distribution of discharge rates of psychiatric patients in Greece, nationwide, is shown.
Method:
Utilization rates are estimated by the number of discharged patients from all public and private mental hospitals for the period 1978-1993.
Results:
During this period six prefectures were repeatedly found to exhibit the highest discharge rates for both sexes. Five out of those six areas are mountainous, socially isolated and of a lower level of socioeconomic development, lacking mental health services. The correlation coefficients for the annual mean age-standardized discharge rates of psychiatric patients and the corresponding General Index of Development score of each area were found to be statistically significant for all diagnoses, and for schizophrenic psychoses taken separately, in each prefecture for each of those years (1978-1993).
Conclusions:
It seems that the higher the hospital treated psychiatric morbidity is, the lower is the level of general socioeconomic development of the area. It is possible that families from socially disadvantaged areas, with limited support resources, are unable to avoid the hospitalization of their mentally ill members.