Impact of travel distance on the disposition of patients presenting for emergency psychiatric care

For veterans presenting for emergency psychiatric care, this research teste d the hypothesis that patients with poor geographic accessibility to ambula tory mental health services would be more likely to be hospitalized. Logist ic regression results indicated that distant patients (> 60 miles) were 4.8 times more likely (p < .05) to be admitted for acute psychiatric treatment than were proximal patients (< 60 miles), controlling for clinical and dem ographic case-mix factors. This finding suggests that the Department of Vet erans Affairs might be less effective in its effort to substitute intensive outpatient care in place of expensive inpatient treatment for rural vetera ns with emergent mental health problems.