Authors
Fisher, William H.Simon, Lorna J.
Geller, Jeffrey L.
Penk, Walter E.
Irvin, Elizabeth A.
White, Carla L.
UMass Chan Affiliations
Department of PsychiatryDocument Type
Journal ArticlePublication Date
1996-03-01Keywords
AdolescentAdult
Aged
Cross-Sectional Studies
Female
*Health Facility Size
Health Surveys
Hospitalization
Hospitals, State
Humans
Length of Stay
Male
Mental Disorders
Mental Health Services
Middle Aged
Social Support
United States
Health Services Research
Mental and Social Health
Psychiatric and Mental Health
Psychiatry
Psychiatry and Psychology
Metadata
Show full item recordAbstract
OBJECTIVE: The study examined whether local variations in levels of community-based services affect the case mix of state hospitals undergoing census reduction. METHODS: Trends in case mix over a 14-year period were analyzed at two Massachusetts state hospitals, one of which underwent more rapid census reduction due to expanded community resources in the catchment area it served. Data on patients' hospital use and on sociodemographic and diagnostic characteristics obtained from 1977, 1986, and 1991 assessments of the hospitals' populations were compared. These time points represented the beginning, midpoint, and end of the census reduction period. Data from 1991 on patients' behavioral and functional status were also examined. RESULTS: Parallel trends on many dimensions were evident at the two hospitals as their censuses fell. By 1986 the hospital operating in the area with greater community services had fewer elderly and long-stay patients but a higher number of admissions per patient. In 1991 this hospital's population also had more patients with high-risk violent behaviors and lower levels of functioning. CONCLUSIONS: Although alternative treatment settings allow diversion of many types of patients from state hospitals, expanded community-based services and alternative inpatient beds have not diverted some patient subgroups, including recidivists and patients with behaviors that present risks in other settings. Plans for meeting the clinical needs and behavioral challenges posed by such patients must be part of any further deinstitutionalization or privatization efforts.Source
Psychiatr Serv. 1996 Mar;47(3):255-62.Permanent Link to this Item
http://hdl.handle.net/20.500.14038/45070PubMed ID
8820548Related Resources
Link to Article in PubMedCollections
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