Geospatial Investigations in Colombia Reveal Variations in the Distribution of Mood and Psychotic Disorders

Geographical variations in mood and psychotic disorders have been found in upper-income countries. This study investigated geographic variation in these disorders in Colombia, a middle-income country, analyzing electronic health records from the Clínica San Juan de Dios Manizales (CSJDM). A friction surface map of Caldas was constructed to calculate travel time to the CSJDM for 16,295 patients with mood or psychotic disorders. A zero-inflated negative binomial regression model determined the relationship between travel time and incidence, stratified by disease severity. Spatial scan statistics identified patient clusters. Results showed a distance-decay relationship for outpatients but not inpatients. Nine clusters/hotspots of inpatients were identified. Inequities in healthcare access were revealed, suggesting resource targeting to address treatment inequities and investigate factors generating hotspots.

Janet Song, Mauricio Castaño Ramírez, Justin T. Okano, Susan K. Service, Juan de la Hoz, Ana M. Díaz-Zuluaga, Cristian Vargas Upegui, Cristian Gallago, Alejandro Arias, Alexandra Valderrama Sánchez, Terri Teshiba, Chiara Sabatti, Ruben C. Gur, Carrie E. Bearden, Javier I. Escobar, Victor I. Reus, Carlos Lopez Jaramillo, Nelson B. Freimer, Loes M. Olde Loohuis, Sally Blower