Educational level and hospital use in mental disorders. A population-based study

Area of Science:

• Public Health
• Psychiatry
• Sociology

Background:

• Socioeconomic status is a known determinant of health outcomes, including mental health.
• Previous research indicates variations in mental disorder prevalence across socioeconomic strata.
• Understanding disparities in psychiatric inpatient care is crucial for equitable healthcare delivery.

Purpose of the Study:

• To investigate socioeconomic differences in psychiatric inpatient care utilization by specific mental disorder diagnoses.
• To analyze hospitalization rates, first-time admission rates, and hospitalization risk based on educational attainment.
• To examine gender-specific socioeconomic gradients in psychiatric inpatient care.

Main Methods:

• Population-based study utilizing data from the Finnish National Hospital Discharge Register.
• Inclusion of all major mental disorders (ICD-9 classification) among Finnish adults aged 25-64.
• Socioeconomic status defined by years of education from population census data.

Main Results:

• Discharge and first-time admission rates, along with hospitalization risk, were 2- to 4-fold higher in the low educational group compared to the highly educated population.
• The socioeconomic gradient was most pronounced for schizophrenia.
• No socioeconomic gradient was found for major affective disorders, though bipolar disorder was most prevalent in the highest educational category. Gender differences were noted, with lower gradients among women for most conditions.

Conclusions:

• Hospitalization for most mental disorders is significantly more common in lower socioeconomic groups in Finland.
• The study highlights a clear socioeconomic gradient in psychiatric inpatient care, particularly for conditions like schizophrenia.
• Findings suggest that socioeconomic factors play a substantial role in accessing psychiatric inpatient services, with notable variations by diagnosis and gender.