Private psychiatry and Medicare: Regional equality of access in Australia?

Williams, Robert H.; Doessel, D.P.

doi:10.1080/09638230802053375

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…There are the usual forces of more conventional economic factors, and this also includes the time-price of geographic access. Evidence is now available of the spatial inequity of access to psychiatric services in Australia under Medicare (Williams and Doessel, 2009).…”

Section: Other Matters For Discussionmentioning

confidence: 99%

Resource Misallocation in Australia’s Mental Health Sector under Medicare: Evidence from Time-series Data*

Doessel

Williams

2011

Economic Papers: A Journal of Applied Economics and Policy

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Evidence of poor correspondence between resources and “need” in mental health sectors is accumulating. This non‐correspondence relates to the tendency for some people with mental disorders not to receive services and some people without mental disorders to use services subsidised under Medicare. Time‐series Australian data are examined here and an appropriate approach is applied to measure the correspondence of Australian Bureau of Statistics (ABS) epidemiological surveys of mental disorders and the enumeration of consumers of mental health services under Medicare. The extent of this “structural imbalance” is determined to be extensive. This result reflects a sector beset with incomplete information. Diagnostic efficacy, and funding efficacious processes, is vital economically for the allocation of scarce mental health resources, not just clinically for efficacious therapy. Relevant policy is yet to be formulated.

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Section: Other Matters For Discussionmentioning

confidence: 99%

Resource Misallocation in Australia’s Mental Health Sector under Medicare: Evidence from Time-series Data*

Doessel

Williams

2011

Economic Papers: A Journal of Applied Economics and Policy

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“…All statistical analyses were performed using the STATA (Ver.9 for Windows) and two-tailed p values of less than 0.05 were regarded as statistically significant. Although there were several measurements to report the geographic distributions [ 10 , 19 ], this study used the mean numbers of judo therapy facilities per 100,000 people with their Gini indices according to our previous studies [ 14 , 15 ] and Japanese other studies [ 6 , 10 ]. The Gini indices were calculated based on Lorenz curve, and the procedure of the calculation was as follows.…”

Section: Methodsmentioning

confidence: 99%

Increased number of Judo therapy facilities in Japan and changes in their geographical distribution

Inoue

Nakao

Nomura

et al. 2011

BMC Health Serv Res

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BackgroundJudo therapy is a well established Japanese co-medical profession specializing in outpatient manual treatment of fractures and sprains. Recently, the number of judo therapists has been rapidly increasing as a result of proliferation judo therapy academies. This study examines whether such rapid increases have improved geographical distribution of judo therapy facilities in Japan.MethodsThe number of judo therapy facilities and the population in each municipality were obtained from the Web yellow pages and from Japanese census data for 2004, 2006, and 2008, respectively. Lorenz curves and Gini indices were calculated to demonstrate distributions of judo therapy facilities per 100,000 people. A bootstrapped method was used to identify statistical significances of differences in Gini indices.ResultsIn all municipalities, the mean numbers of judo therapy facilities per 100,000 people were 15.3 in 2004, 15.8 in 2006, and 17.6 in 2008. The Gini indices for judo therapy facilities nationally were 0.273 in 2004, 0.264 in 2006, and 0.264 in 2008. The numbers of judo therapy facilities increased significantly between 2006 and 2008 (p < 0.05) but the indices did not change significantly in the same period. The Gini indices for local towns and villages remained unchanged and were consistently higher (p < 0.05) than those in urban areas throughout the study periods.ConclusionOur results suggest that recent increases in the number of judo therapy facilities have not necessarily led to greater equality in their geographic distribution in terms of Gini indices.

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“…The distribution and utilization of psychiatric resources has been quantified with Lorenz curves [63][64][65][66] , although other questions have also been addressed [67][68][69][70] . However, (direct) Lorenzian inequality analysis is univariate, which limits applicability to modern translational psychiatric research.…”

Section: Inequality Indices For Comparing Heterogeneity Of Differentlmentioning

confidence: 99%

The definition and measurement of heterogeneity

2020

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Heterogeneity is an important concept in psychiatric research and science more broadly. It negatively impacts effect size estimates under case-control paradigms, and it exposes important flaws in our existing categorical nosology. Yet, our field has no precise definition of heterogeneity proper. We tend to quantify heterogeneity by measuring associated correlates such as entropy or variance: practices which are akin to accepting the radius of a sphere as a measure of its volume. Under a definition of heterogeneity as the degree to which a system deviates from perfect conformity, this paper argues that its proper measure roughly corresponds to the size of a system's event/sample space, and has units known as numbers equivalent. We arrive at this conclusion through focused review of more than 100 years of (re)discoveries of indices by ecologists, economists, statistical physicists, and others. In parallel, we review psychiatric approaches for quantifying heterogeneity, including but not limited to studies of symptom heterogeneity, microbiome biodiversity, cluster-counting, and time-series analyses. We argue that using numbers equivalent heterogeneity measures could improve the interpretability and synthesis of psychiatric research on heterogeneity. However, significant limitations must be overcome for these measures-largely developed for economic and ecological research-to be useful in modern translational psychiatric science.

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Private psychiatry and Medicare: Regional equality of access in Australia?

Cited by 5 publications

References 23 publications

Resource Misallocation in Australia’s Mental Health Sector under Medicare: Evidence from Time-series Data*

Resource Misallocation in Australia’s Mental Health Sector under Medicare: Evidence from Time-series Data*

Increased number of Judo therapy facilities in Japan and changes in their geographical distribution

The definition and measurement of heterogeneity

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