Patterns in the delivery of psychiatric care in Saskatchewan 1971-72: an overview of service sectors and patient volumes.

Abstract

For the purpose of examining patterns in the delivery of psychiatric services in the province of Saskatchewan during 1971 and 1972, a research data file was created containing data on all persons who had received medical treatment for explicitly psychiatric disorders: from PSB; from a physician paid on a fee-for-service basis under MCIC; and/or in a provincial general hospital. The resulting data file provides a history of the psychiatric care utilization behaviour of all patients who have been treated for a psychiatric illness in the province during the period January 1st, 1971 to December 31st, 1972, irrespective of the facilities in which this treatment was delivered. This data file, since it has keyed on explicitly psychiatric diagnoses and on diagnoses rather than type of service delivered, will give conservative estimates on the number of patients and patterns of contacts. During the two-year period a total of 123,099 received some form of psychiatric treatment. There were six times as many patients seen by fee-for-service physicians as by the ‘public’ sector. In both sectors the majority of patients were seen on an outpatient basis. Patients in the ‘private’ sector were usually seen by general practitioners. There appear to be two relatively autonomous sectors involved in the delivery of psychiatric care to different population segments. There was also a significant ‘turnover’ in the provincial psychiatric population, with patients receiving treatment in one year but not in the other. The data could be interpreted to suggest that the majority of persons seen for psychiatric reasons by medical practitioners are suffering from relatively minor psychiatric ailments. This raises the whole question of the suitability of the service delivery system and the question of manpower substitution. Alternatively, it could be argued that these data, both the large number of outpatients and the considerable yearly turnover in the provincial psychiatric population, indicate that psychiatric problems are now essentially amenable to treatment.