The failure of the diversion process: The impact of transferring of patients to state hospitals
Tóm tắt
The diversion of people with severe mental illness into the private sector is examined. The purpose of the diversion system is to reduce the number of admissions to the state hospitals by diverting patients into the private hospitals, which may offer more diverse treatment to these patients. Insurance is highlighted as an important factor in diverting patients from state hospitals. When the diversion system fails and the patient is transferred from the private sector to the state hospitals, continuity of care is disrupted. The failure of the diversion is more costly not only to the patient but to the federal and state governments as well. Policy issues such as cost to the mental health system and continuity of care are discussed.
Tài liệu tham khảo
Gray BH, McNerney WF: For-profit enterprise in health care.New England Journal of Medicine 1986; 314:1523–1528.
Shapiro JG: Patients refused admission to a psychiatric hospital.Hospital and Community Psychiatry 1983; 34:733–736.
Geller JL: Any place but the state hospital: Examining assumptions about the benefits of admission diversion.Hospital and Community Psychiatry 1991, 42:145–152.
Dorwart RA, Schlesinger M, Davidson H, et al.: A national study of psychiatric hospital care.American Journal of Psychiatry 1991; 148:204–210.
Osbourne OH, Murphy H, Leichman SS, et al.: Forced relocation of hospitalized psychiatric patients.Archives of Psychiatric Nursing 1990; 4:221–227.
Stone AA: Psychiatric abuse and legal reform: Two ways to make a bad situation worse.International Journal of Law and Psychiatry 1982; 5:9–28.
Bachrach LL: Continuity of care for chronic mental patients: A conceptual analysis.American Journal of Psychiatry 1981; 138:1449–1456.
Wellin E, Slesinger DP, Hollister CD: Psychiatric emergency services: Evolution, adaptation, and proliferation.Social Science and Medicine 1987; 24:475–482.
Stroul BA: Residential crisis services: A review.Hospital and Community Psychiatry 1988; 39:1095–1099.
Fisher WH, Geller JL, Altaffer F, et al. The relationship between community resources and state hospital recidivism.American Journal of Psychiatry 1992; 149:385–390.
Wolff N, Henderson PR, MacAskill RL, et al.: Treatment patterns for schizophrenia in psychiatric hospitals.Social Science and Medicine 1982; 28:323–331.
Rosenstein MJ, Milazzo-Sayre LJ, Manderscheid RW: Care of persons with schizophrenia: A statistical profile.Schizophrenia Bulletin 1989; 15:45–58.
Zubin J, Spring B: Vulnerability: A new view of schizophrenia.Journal of Abnormal Psychology 1977; 86:103–126.
Cancro R: The role of genetic factors in the etiology of the schizophrenic disorders. In: Grinspoon L (Ed.),Psychiatry:1982 Annual Review. Washington, DC: American Psychiatric Association, pp. 2221–2225.
Gerson S, Bassuk E: Psychiatric emergencies: An overview.American Journal of Psychiatry 1980; 137:1–11.
Wilder JF, Karasu TB: Games institutions play: An exclusionary plot.Hospital and Community Psychiatry 1977; 28:459–460.
Matthews DB:Disposable Patients: Situational Factors in Emergency Psychiatric Decisions. Lexington, MA: Lexington Books, 1980.
Apsler R, Bassuk E: Differences among clinicians in the decision to admit.Archives of General Psychiatry 1983; 40:1133–1177.
Ianzito BM, Fine J, Sprague B, et al.: Overnight admission for psychiatric emergencies.Hospital and Community Psychiatry 1978; 29:728–730.
Evenson R, Waite J, Holland R: Admission decisions in the psychiatric emergency room.Comprehensive Psychiatry 1983; 24:90–93.
Friedman S, Margolis R, David OJ, et al.: Predicting psychiatric admissions from an emergency room.Journal of Nervous and Mental Disease 1983; 171:155–158.
Friedman RS: Hospital treatment of psychiatric emergencies.Psychiatric Clinic of North America 1983; 6:293–303.
Marson DC, McGovern MP, Pomp HC: Psychiatric decision making in the emergency room: A research overview.American Journal of Psychiatry 1988; 145:918–925.
Mendel WM, Rapport S: Determinations of the decision for psychiatric hospitalization.Archives of General Psychiatry 1969; 20:321–328.
Streiner DL, Goodman JT, Woodward CA: Correlates of the hospitalization decision: A replicative study.Canadian Journal of Public Health 1975; 66:411–415.
Swift RM: Negotiating psychiatric hospitalizations with restrictive admissions criteria.Hospital and Community Psychiatry 1986; 37:619–623.
Schlesinger M, Bentkover J, Blumenthal D, et al.: The privatization of health care and physician's perception of access to hospital services: Profits, competition and multihospital corporation.Milbank Quarterly 1987; 65:25–58.
Ciompi L: Catamnestic long-term study on the course of life and aging of schizophrenics.Schizophrenia Bulletin 1980; 6:606–618.
Freedman RI, Moran A: Wanders in a promised land: The chronically mentally ill and deinstitutionalization.Medical Care 1984: 22(12):S1-S60.
Belcher JR: The homeless mentally ill and the need for a total care environment.Canadian Journal of Psychiatry 1989; 34:186–189.
Holcomb WR, Abr PR: Who really treats the severely impaired young adult patients? A comparison of treatment settings.Hospital and Community Psychiatry 1987; 38:625–630.
Taube C: Funding and expenditures for mental illness. In: Manderscheid RW (Ed.),Mental Health in the United States. Washington, DC: U.S. Govt. Printing Office, 1990, pp. 216–226.
Frank RG, Salkever DS, Sharfstein SS: A new look at rising mental health insurance costs.Health Affairs 1991; 10:116–123.
Frank RG: The medically indigent mentally ill: Approaches to financing.Hospital and Community Psychiatry 1989; 40:9–12.
Belcher JR: The trade-offs of developing a case management model for the chronically mentally ill.Health and Social Work 1993; 18:1–80.
Foley HA, Sharfstein SS:Madness and Government: Who Cares for the Mentally Ill? Washington, DC: American Psychiatric Press, 1983.
Hadley TR, McGurrin MC, Pulice, RT, et al.: Using fiscal data to identify heavy service users.Psychiatric Quarterly 1990; 61:41–48.
Surber RW, Winkler EL, Monteleone M, et al.: Characteristics of high users of acute psychiatric inpatient services.Hospital and Community Psychiatry 1987; 38:1112–1114.
Surles RC, McGurrin MC: Increased use of psychiatric emergency services.Hospital and Community Psychiatry 1987; 38:401–405.
Bentley KJ:Analysis of Legislative Mandates to Support Community-Based Care: A Report to the Commissioner. Richmond, VA: Department of Mental Health, Mental Retardation, and Substance Abuse Services, 1991.
Sharfstein SS, Stoline AM, Goldman HH: Psychiatric care and health insurance reform.American Journal of Psychiatry 1993; 150:7–18.
Brown P, Cooksey E: Mental health monopoly: Corporate trends in mental health services.Social Science and Medicine 1989; 28:1129–1138.
Gronfein W: Psychotropic drugs and origins of deinstitutionalization.Social Problems 1985; 32:437–454.
Belcher JR: Are jails replacing the mental health system for the homeless mentally ill?Community Mental Health Journal 1988; 24:185–195.