A framework for the analysis of psychiatric health facility utilization

Existing research that examines the general problem of health facility use often lacks sound theoretical specification. This problem is partly a function of conceptual difficulties in explaining health seeking behaviour and an absence of appropriate data with which to calibrate modelling endeavours. These problems are addressed in this paper where a logit model of health seeking behaviour and health facility use derived from discrete choice theory is presented. The structure of the model is general but in this case it is developed in the context of mental health facility use. A data set from Auckland, New Zealand is utilized to apply the modelling ideas presented. Results show that discrete choice theory can be adapted to the problem of mental health facility usage under conditions where the health care system offers real choice at any given level of care. In this case real choice implies a well-developed array of alternative facilities to choose from.