Definition of partial hospitalization. The National Association of Private Psychiatric Hospitals and the American Association for Partial Hospitalization.

Abstract

The National Association of Private Psychiatric Hospitals (NAPPH) recently joined with the American Association for Partial Hospitalization (AAPH) to provide mental health professionals with a clear, industry-supported definition of psychiatric partial hospitalization, an option on the continuum of care used by clinicians to treat mental illnesses. In 1988, Congress approved a major benefit change for the Title XVIII Medicare program by including reimbursement for partial hospital programs that meet a strict definition and provide a series of treatment services. As defined by Congress, partial hospitalization means an outpatient program specifically designed for the diagnosis or active treatment of a serious mental disorder when there is a reasonable expectation for improvement or when it is necessary to maintain a patient's functional level and prevent relapse or full hospitalization. That definition and the service components are endorsed by NAPPH and AAPH, and they offer a model for other insurers or employers considering the addition of this highly specialized program to healthcare benefit plans. Partial hospital programs are usually furnished by a hospital as a distinct and organized intensive ambulatory treatment service of less than 24-hour daily care. Partial hospitalization is not a substitute for inpatient care. For some patients, the availability of partial hospitalization may shorten the length of stay of full hospitalization or serve as a transition from inpatient to outpatient care. It may allow some patients to avoid hospitalization. Placement in a partial hospital program is a clinical decision that can be made only by a physician thoroughly knowledgeable about the patient's illness, history, environment, and support system.