Relationship between utilization of mental health and medical services in a VA hospital

Article Abstract:

Previous studies have found that when patients begin to receive psychiatric care, their use of medical services decreases. This has been referred to as the 'offset effect', in which both the use and cost of medical services is reduced following the commencement of psychotherapy. Few studies have been conducted which address this phenomenon in conjunction with treatment that requires no payment. To investigate this situation, the records of patients treated at a Veterans Administration hospital were reviewed. One hundred forty-five patients were identified who used psychiatric services, and another 145 patients were selected who did not. Significant reductions in the use of medical services were observed in the group that received psychiatric care, during the first year following initiation of this care. This reduction was only evident in patients who had high rates of use for medical care and who received psychiatric treatment for periods of one year or less; patients who received continuing mental health care did not demonstrate an offset effect. In conclusion, substantial health care cost reductions may be achieved by introducing psychiatric care to medical outpatients, as is demonstrated by the correlation between initiation of short-term psychiatric treatment and reduction in use of medical services. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Research, Medical care, Cost of, Health care costs, Psychotherapy, Hospital outpatient services, Hospitals, Veterans', Veterans hospitals

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Evaluating and treating violent adolescents in the managed care era

Article Abstract:

The cost-containment practices of the managed care environment have incited concerns from psychiatrists who care for teenagers at risk of becoming violent. Under a managed care structure, the insurance company dictates and decides which therapies may be given to specific patients. Clinical studies showed that the health maintenance organizations exercise broad powers in deciding who gets treatment, when and how much can be given. Psychiatrists have to surmount the ethical restrictions set by the managed care environment to provide complete care to their patients.

Psychological aspects, Analysis, Case studies, Teenagers, Youth, Managed care plans (Medical care), Violence

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Cost-effectiveness of psychiatric care

Article Abstract:

The cost effectiveness of psychiatric care is best evaluated through methods that seek to establish the divergence among alternative interventions or treatments. Current cost-effectiveness evaluation methods lack consistency and uniformity of criteria and measurement results are arbitrary and variable. The best method would rationalize resource allocation and help policymakers create a wise health care policy.

Editorial

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