Geographic Variation in First Admission Rates to a State Mental Hospital

It has been hypothesized that mental hospital first admission rates are related inversely to the distance between the hospital and patients' place of residence. This paper presents a detailed model for analyzing the spatial distribution of first admission rates to a single State mental hospital by taking into account the factors of distance and direction of patients' residence from the hospital as well as type of residential area, urban or rural. Distance is measured in terms of zones around the hospital, the zones being constructed theoretically as concentric circles and approximated by township lines. The hospital service area is divided into quadrants based on township lines and urban areas are defined within each quadrant-zone segment. First admission rates are based on U.S. Census of Population data. Applying this model to data from a single hospital produces an overall pattern of decreasing first admission rates with increasing distance from the hospital. Detailed examination of the data by psychiatric diagnosis reveals that the decreasing pattern is present for some diagnostic groups of patients and not for others. The pattern may possibly relate to several hypothetical factors, two of which are availability of psychiatric facilities other than the State mental hospital and the reaction of individuals, families, and communities to the distance at which the hospital is located when other local psychiatric facilities are not available.