University of Oulu

Lankila, T., Laatikainen, T., Wikström, K. et al. Association of travel time with mental health service use in primary health care according to contact type — a register-based study in Kainuu, Finland. BMC Health Serv Res 22, 1458 (2022).

Association of travel time with mental health service use in primary health care according to contact type : a register-based study in Kainuu, Finland

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Author: Lankila, Tiina1; Laatikainen, Tiina2,3,4; Wikström, Katja2,3;
Organizations: 1Geography Research Unit, University of Oulu, P.O Box 8000, 90014, Oulu, Finland
2Department of Public Health and Social Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
3Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
4Joint Municipal Authority for North Karelia Social and Health Services, (Siun Sote), Tikkamäentie 16, 80210, Joensuu, Finland
5Department of Health and Social Care Management, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
6Institute of Healthcare Engineering, management and architecture, Aalto University, Espoo, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.1 MB)
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Language: English
Published: Springer Nature, 2022
Publish Date: 2022-12-05


Background: The study aim was to analyse how mental health services are used in different parts of the Kainuu region in Finland and whether travel time to primary health care services is associated with the use of different contact types (in-person visits, remote contacts, home visits).

Methods: The study population included adults who had used mental health services under primary health care (N = 7643) between 2015 and 2019. The travel times to the nearest health centre in a municipality were estimated as the population-weighted average drive time in postal code areas. The Kruskal–Wallis test and pairwise comparisons with Dunn-Bonferroni post hoc tests were used to assess the differences in mental health service use between health centre areas. A negative binomial regression was performed for the travel time categories using different contact types of mental health service use as outcomes. Models were adjusted for gender, age, number of mental health diseases and the nearest health centre in the municipality.

Results: Distance was negatively associated with mental health service use in health centre in-person visits and in home visits. In the adjusted models, there were 36% fewer in-person visits and 83% fewer home visits in distances further than 30 min, and 67% fewer home visits in a travel time distance of 15–30 min compared with 15 min travel time distance from a health centre. In the adjusted model, in remote contacts, the incidence rate ratios increased with distance, but the association was not statistically significant.

Conclusions: The present study revealed significant differences in mental health service use in relation to travel time and contact type, indicating possible problems in providing services to distant areas. Long travel times can pose a barrier, especially for home care and in-person visits. Remote contacts may partly compensate for the barrier effects of long travel times in mental health services. Especially with conditions that call for the continuation and regularity of care, enabling factors, such as travel time, may be important.

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Series: BMC health services research
ISSN: 1472-6963
ISSN-E: 1472-6963
ISSN-L: 1472-6963
Volume: 22
Article number: 1458
DOI: 10.1186/s12913-022-08815-4
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This study is a part of the consortium project “Improving the Information Base and Optimising Service Solutions to Support Social Welfare and Healthcare Reform (IMPRO)”. The research was funded by the Strategic Research Council at the Academy of Finland, funding decision numbers 312703, 312705, 312707, 336325, 336327 and 336329.
Academy of Finland Grant Number: 312705
Detailed Information: 312705 (Academy of Finland Funding decision)
336327 (Academy of Finland Funding decision)
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