Psychiatric Hospital Care and Changes in Insurance Coverage Strategies: a National Study

Overview

Journal J Ment Health Adm

Specialty Health Services

Date 1995 Oct 1

PMID 10152007

Authors

J R BELCHER

B R DeForge

J W Thompson

C P Myers

Affiliations

Soon will be listed here.

Abstract

The 1975, 1980, and 1986 sample surveys from the National Institute of Mental Health were used to predict the type of inpatient psychiatric facility where people were admitted. Predictors used were demographics (age, gender, race, marital status, and education), psychiatric diagnosis, and insurance status (primary payment source). A discriminant analysis revealed that insurance status was the most important discriminator in predicting hospital type. State hospitals were more likely to care for patients with little or no resources, whereas private hospitals cared for patients with some form of insurance. The authors discuss the implications of insurance status and access to psychiatric treatment.

References

Mechanic D, Surles R . Challenges in state mental health policy and administration. Health Aff (Millwood). 1992; 11(3):34-50. DOI: 10.1377/hlthaff.11.3.34. View

DORWART R, Schlesinger M, Davidson H, Epstein S, Hoover C . A national study of psychiatric hospital care. Am J Psychiatry. 1991; 148(2):204-10. DOI: 10.1176/ajp.148.2.204. View

Hogan M . New futures for mental health care: the case of Ohio. Health Aff (Millwood). 1992; 11(3):69-83. DOI: 10.1377/hlthaff.11.3.69. View

Petchers M, Milligan S . Access to health care in a black urban elderly population. Gerontologist. 1988; 28(2):213-7. DOI: 10.1093/geront/28.2.213. View

GROB G . Mental health policy in America: myths and realities. Health Aff (Millwood). 1992; 11(3):7-22. DOI: 10.1377/hlthaff.11.3.7. View

Schlesinger M, Bentkover J, Blumenthal D, Musacchio R, Willer J . The privatization of health care and physicians' perceptions of access to hospital services. Milbank Q. 1987; 65(1):25-58. View

FELDSTEIN P, Wickizer T, Wheeler J . Private cost containment. The effects of utilization review programs on health care use and expenditures. N Engl J Med. 1988; 318(20):1310-4. DOI: 10.1056/NEJM198805193182006. View

BELCHER J . Are jails replacing the mental health system for the homeless mentally ill?. Community Ment Health J. 1988; 24(3):185-95. DOI: 10.1007/BF00757136. View

Gray B, McNerney W . For-profit enterprise in health care. The Institute of Medicine Study. N Engl J Med. 1986; 314(23):1523-8. DOI: 10.1056/NEJM198606053142335. View

10.

BORENSTEIN D . Managed care: a means of rationing psychiatric treatment. Hosp Community Psychiatry. 1990; 41(10):1095-8. DOI: 10.1176/ps.41.10.1095. View

11.

Leaf P, Bruce M, Tischler G, Freeman Jr D, Weissman M, MYERS J . Factors affecting the utilization of specialty and general medical mental health services. Med Care. 1988; 26(1):9-26. DOI: 10.1097/00005650-198801000-00002. View

12.

BELCHER J, Palley H . The prospects for national health insurance reform. Soc Work Health Care. 1991; 15(3):101-19. DOI: 10.1300/J010v15n03_06. View

13.

Bond G, Miller L, Krumwied R, Ward R . Assertive case management in three CMHCs: a controlled study. Hosp Community Psychiatry. 1988; 39(4):411-8. DOI: 10.1176/ps.39.4.411. View

14.

Thompson J, Goldman H . The NIMH translation from DSM-II/ICDA-8 to DSM-III/ICD-9-CM using grouped codes. Ment Health Stat Note. 1983; (163):1-8. View

15.

Fisher W, Geller J, Altaffer F, Bennett M . The relationship between community resources and state hospital recidivism. Am J Psychiatry. 1992; 149(3):385-90. DOI: 10.1176/ajp.149.3.385. View

16.

Williams D . The epidemiology of mental illness in Afro-Americans. Hosp Community Psychiatry. 1986; 37(1):42-9. DOI: 10.1176/ps.37.1.42. View

17.

Gay E, Kronenfeld J, Baker S, Amidon R . An appraisal of organizational response to fiscally constraining regulation: the case of hospitals and DRGs. J Health Soc Behav. 1989; 30(1):41-55. View