Examining The Care Pathways Patients Experience When Accessing Outpatient Psychiatric Care in British Columbia
Bibliographic record
Abstract
The British Columbia (BC) mental health roadmap prioritizes equitable access to care. This study investigates the equity of care pathways experienced by BC residents accessing outpatient psychiatric care for the first time. Community-based care pathways are paramount as they indicate timely access to care and are less expensive for the health system. We analyzed linked administrative BC health data spanning April 1st 2013, to March 31st 2022, to study how sociodemographic factors relate to accessing psychiatric care pathways. Pathways to outpatient psychiatric care include a community-based pathway, hospitalization to primary care to outpatient psychiatry, and hospitalization directly to outpatient psychiatry. Sociodemographic factors considered were administrative sex, immigration recency and status, neighbourhood income quintile and being a recipient of a low-income drug plan. These relationships were analyzed using multinomial logistic regression, adjusting for age, location, fiscal year, and stratifying by mental disorder diagnoses. Being male, a low-income drug plan recipient, living in a lower income neighbourhood, or being a recent economic immigrant or permit holder was associated with increased odds of accessing outpatient psychiatric care via either hospitalization pathway. Having a diagnosis of schizophrenia/bipolar disorder was independently associated with both hospitalization pathways, and this diagnosis exacerbated the magnitude of the estimates for the sociodemographic characteristics. We find clear disparities in pathways to accessing outpatient psychiatric care. These disparities indicate health system failures in addressing specific population needs, highlighting the importance of targeted interventions, such as increasing the number of community health workers, to achieve equitable mental health care in BC.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".