Geospatial investigations in Colombia reveal variations in the distribution of mood and psychotic disorders

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Janet Song1, Mauricio Castaño Ramírez2, Justin T Okano3

  • 1Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

Communications Medicine
|February 21, 2024
PubMed

Insights

Geographic access to mental healthcare in Colombia is unequal. Long travel times disproportionately affect outpatient access, highlighting the need to address healthcare inequities, especially in identified patient hotspots.

Area of Science:

  • Mental Health Research
  • Health Services Research
  • Spatial Epidemiology

Background:

  • Geographic variations in mood and psychotic disorders are documented in high-income nations.
  • This study investigates geographic variations in these disorders within Colombia, a middle-income country.
  • Analysis utilizes electronic health records from Clínica San Juan de Dios Manizales (CSJDM), serving one million inhabitants of Caldas.

Purpose of the Study:

  • To examine geographic variations in mood and psychotic disorders in Colombia.
  • To assess the relationship between travel time to a mental healthcare facility and disorder incidence.
  • To identify potential disparities in access to mental health services.

Main Methods:

  • Constructed a friction surface map of Caldas to calculate travel times to CSJDM.
  • Analyzed travel times for 16,295 patients diagnosed with mood or psychotic disorders.
  • Utilized zero-inflated negative binomial regression and spatial scan statistics to analyze incidence and identify patient clusters.

Main Results:

  • Approximately 50% of the population has travel times under 1 hour to CSJDM, while 10% face over 4 hours.
  • A significant distance-decay relationship was observed for outpatients (RR=0.80), with a 20% decrease in cases per hour increase in travel time.
  • No distance-decay relationship was found for inpatients.
  • Nine distinct clusters or hotspots of inpatient cases were identified.

Conclusions:

  • The findings reveal healthcare access inequities, with long travel times potentially hindering outpatient treatment.
  • Targeting resources to identified hotspots could improve identification of severely ill individuals.
  • Further investigation into the factors contributing to these hotspots is warranted to address treatment disparities.
Abstract

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