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dc.contributor.authorWhite, Carla L.
dc.contributor.authorBateman, Anne
dc.contributor.authorFisher, William H.
dc.contributor.authorGeller, Jeffrey L.
dc.date2022-08-11T08:10:23.000
dc.date.accessioned2022-08-23T17:06:20Z
dc.date.available2022-08-23T17:06:20Z
dc.date.issued1995-05-01
dc.date.submitted2010-11-18
dc.identifier.citationPsychiatr Serv. 1995 May;46(5):467-72.
dc.identifier.issn1075-2730 (Linking)
dc.identifier.pmid7627670
dc.identifier.urihttp://hdl.handle.net/20.500.14038/45068
dc.description.abstractOBJECTIVE: The study examined factors associated with admission to public and private hospitals from a mental health care emergency screening system operating under a longstanding mandate to maximize use of private inpatient treatment. METHODS: For 206 patients evaluated at the mental health emergency screening site over a two-and-a-half-month period, data were collected on demographic and clinical characteristics, admission history, services received during the emergency encounter, system variables such as time the patient spent at the emergency screening site, number of admission sites asked to accept the patient, and all reasons cited by providers for refusing to admit the patient. Logistic regression was used to develop a model of factors most likely and least likely to be associated with private hospitalization. RESULTS: Overall, 60 percent of the sample was refused admission by one or more providers, and 55 percent, who were not accepted by and private hospital, became public patients. Private hospital admission was associated with patient or family involvement in referral and disposition, private or Medicaid insurance, a presenting problem of depression or suicidality, and longer time spent at the emergency screening site. Public admission was associated with no insurance, a past history of major public hospitalization, current or past history of assaultiveness, a presenting problem of aggression, and lack of any discharge site. CONCLUSIONS: Private providers are reluctant to admit patients who have characteristics associated with public hospitalization. In the restructuring of health care, a more fully privatized system will likely be called on to absorb such patients. Their care, treatment, and impact on the system should be carefully monitored and evaluated.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=7627670&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://ps.psychiatryonline.org/cgi/reprint/46/5/467
dc.subjectAdult
dc.subjectAged
dc.subjectCost Savings
dc.subjectCross-Sectional Studies
dc.subjectDangerous Behavior
dc.subjectEmergency Services, Psychiatric
dc.subjectFemale
dc.subjectHospitals, Private
dc.subjectHospitals, Psychiatric
dc.subjectHospitals, Public
dc.subjectHumans
dc.subjectIncidence
dc.subjectInsurance, Psychiatric
dc.subjectMale
dc.subjectMassachusetts
dc.subjectMental Disorders
dc.subjectMiddle Aged
dc.subjectPatient Admission
dc.subjectReferral and Consultation
dc.subjectRefusal to Treat
dc.subjectUtilization Review
dc.subjectViolence
dc.subjectHealth Services Research
dc.subjectMental and Social Health
dc.subjectPsychiatric and Mental Health
dc.subjectPsychiatry
dc.subjectPsychiatry and Psychology
dc.titleFactors associated with admission to public and private hospitals from a psychiatric emergency screening site
dc.typeJournal Article
dc.source.journaltitlePsychiatric services (Washington, D.C.)
dc.source.volume46
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/psych_cmhsr/177
dc.identifier.contextkey1648079
html.description.abstract<p>OBJECTIVE: The study examined factors associated with admission to public and private hospitals from a mental health care emergency screening system operating under a longstanding mandate to maximize use of private inpatient treatment.</p> <p>METHODS: For 206 patients evaluated at the mental health emergency screening site over a two-and-a-half-month period, data were collected on demographic and clinical characteristics, admission history, services received during the emergency encounter, system variables such as time the patient spent at the emergency screening site, number of admission sites asked to accept the patient, and all reasons cited by providers for refusing to admit the patient. Logistic regression was used to develop a model of factors most likely and least likely to be associated with private hospitalization.</p> <p>RESULTS: Overall, 60 percent of the sample was refused admission by one or more providers, and 55 percent, who were not accepted by and private hospital, became public patients. Private hospital admission was associated with patient or family involvement in referral and disposition, private or Medicaid insurance, a presenting problem of depression or suicidality, and longer time spent at the emergency screening site. Public admission was associated with no insurance, a past history of major public hospitalization, current or past history of assaultiveness, a presenting problem of aggression, and lack of any discharge site.</p> <p>CONCLUSIONS: Private providers are reluctant to admit patients who have characteristics associated with public hospitalization. In the restructuring of health care, a more fully privatized system will likely be called on to absorb such patients. Their care, treatment, and impact on the system should be carefully monitored and evaluated.</p>
dc.identifier.submissionpathpsych_cmhsr/177
dc.contributor.departmentDepartment of Psychiatry
dc.source.pages467-72


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