The scope of this study covers the medical resources of mental disease and the change of proportion in the mental disease cross-region admission in Taiwan. We also analyzed factors influencing the proportion of cross-region admission. The objective is to provide information and suggestions for government and private institutions working in the mental disease area to formulate their policies. We based our study on samples taken from the files of insured person in the database of the National Health Research Institutes. We treat the medical network and the psychiatric care network as two separate geographical regions as our unit of analysis. We use the proportion of cross-region admission of acute and chronic psychiatric patients as the index of the accessibility of the medical care for the mentally ill. We focused our analysis on the following:
?1?The allocation of the medical resources for psychiatric care in Taiwan
?2?The attainability of objectives of the medical policy of the psychiatric care networks
?3?Factors influencing the proportion of cross-region admission between the acute and chronic psychiatric patients
Following are our conclusion in each of the three areas we studied:
?1?The allocation of medical resources for psychiatric patients in Taiwan
The number of medical institutions providing in-patient services has increased from 87 to 108. The ratio of beds for the acute psychiatric patients per 10,000 has increased from 1.72 to 2.24, and that for the chronic psychiatric patients has increased from 3.32 to 4.35. Both are encouraging signs. Although these numbers have not reached the objective of the Plan of the psychiatric care network, they are no small improvement in themselves. The allocation of these services across Taiwan also has shown a noticeable improvement. Among these, the regional hospitals providing Psychiatric Ward and associated services are the major factors influencing the allocation of beds for the mentally afflicted person.
?2?The achievement of the objectives of policy on the psychiatric care network
The proportion of cross-region admission of the acute psychiatric patients has increased from 32.3% to 37.9% and shows no improvement at all. However, the variation of the proportion of cross-region admission has decreased 18%, which means the difference of the cross-region admission has decreased. For the chronic psychiatric patients, the variation of the cross-region admission of the psychiatric care network also did not show any improvement (from 14.4% to 14.5%);. The variation of the proportion on cross-region admission has also decreased 19.1%, which again means the difference of
the cross-region admission among the local psychiatric care networks has decreased.
?3?The factors influencing the proportion of the cross-region admission
The number of beds for the acute psychiatric patients was the major factor affecting the proportion of cross-region admission for emergency mental patients in 1997. In 2001, the impact of the medical resources has noticeably been lowered indicating the supply of the beds has met the needs of the patients somewhat. For the chronic patients, the major factor affecting the proportion of cross-region admission in 1997 was the number of beds for the acute psychiatric patients. This indicates the chronic patient has taken the bed intended for the acute patients, and the phenomenon was widespread. However, in 2001 the number of beds for the chronic patients has become a major factor affecting the proportion of cross-region admission. This in turn indicates the supply of resources has made a remarkable contribution.
From the conclusions we reached above, we strongly recommend that the government should continue to encourage private funding for setting up psychiatric institutions and to balance the interregional resources development to improve the accessibility of psychiatric care for the mentally ill.
