Organizational features of mental health facilities and adequacy of treatment. Multilevel analysis from the italian region lombardy

Introduction Mental healthcare represents a significant issue for the Healthcare System [1]: one of major causes is high heterogeneity in provision care, due to differences among Departments Health (DMHs). Objectives To identify predictors an adequate treatment patients with severe mental disorders (SMDs), both at individual and structural level, latter considering features Psychiatric Operative Units (POUs), Italian region Lombardy. Methods Utilization Databases, collecting data on services provided beneficiaries National Service (NHS), have been used retrieve data. Patients that during 2015 were resident Lombardy; suffered from depressive, bipolar or schizophrenic disorder; contact DMHs, identified. Adequateness has evaluated according Minimally Adequate Treatment (MAT) [2,3]: combination psychiatric visits specific pharmacological treatment, psychotherapeutic sessions. Having received MAT assessed one-year period. Predictive factors classified into two hierarchical levels: (first) level (second) level. At first clinical socio-demographics characteristics each patient. second organizational structure POU examined: number taken community-care facilities, hours worked by class providers (psychiatrists, nurses, psychologists, psychosocial staff ). A log-binomial model evaluate association between first-level having MAT; multilevel second-level considered Results 72115 identified: 33974 (47.1%), 28407 (39.4%) 9734 (13.5%) suffering disorder respectively; 45.4% them (32773 patients) MAT. Compared affected depression, those show higher probability receiving (+23%, +11% respectively). living alone lower MAT, unlike education employment, underlining social burden related SMDs. Organizational proven significant: centres activity volume more facilities seem likely guarantee Moreover, psychiatrists, nurses providing Conclusions SMDs are still untreated appropriate way. highlight importance as well composition multidisciplinary teams working there. Disclosure Interest None Declared