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Abstract
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Introduction
Pain and mental health conditions account for a significant proportion of the public health burden of injury, and treatment patterns can vary by neighbourhood area. We aimed to (a) characterise geographic variations in treatment for pain and mental health conditions across local government areas (LGAs); and (b) examine the relationship between treated condition prevalence and LGA socioeconomic advantage and disadvantage.
Methods
The data comprised adults (18+ years) with an accepted claim (N = 73,796) with the Victorian transport injury compensation scheme from 2008-2013, living in Victoria, Australia, who survived to 24-months post-injury. Exclusions were: no claim payments within 84-days post-injury, surgery >6 weeks post-injury and catastrophic injury. Treated conditions were identified 3-24 months post-injury using previously developed criteria from administrative records of funded medications and clinician-based treatments. Geospatial patterns of treated conditions were examined using hierarchical Bayesian spatial logistic regression models.
Results
Treated condition incidence was higher in metropolitan LGAs (pain: 7.0%, 96.45 per 100,000; mental health: 3.4%, 46.82 per 100,000) than regional LGAs (pain: 3.8%, 53.27 per 100,000; mental health: 2.2%, 29.63 per 100,000). In metropolitan LGAs, higher neighbourhood disadvantage was associated with higher prevalence of treated pain (r2 = −0.50, 95%CI:-0.72,-0.17) and mental health (r2 = −0.63, 95%CI:-0.81,-0.36). In regional LGAs, higher neighbourhood disadvantage was correlated with lower prevalence of treated pain (r2 = 0.39, 95%CI:0.11,0.62), but not mental health (r2 = 0.15, 95%CI: −0.15,0.44).
Conclusions
Strategies to support timely and equitable treatment for pain and mental health post-injury must account for the potential role of social and geographic determinants of treatment use, which will vary between regional and metropolitan areas.
Language: en |