Journal of mental health administration最新文献_第4页

State health care reforms: how they affect children and adolescents with emotional disorders and their families. 国家卫生保健改革:它们如何影响患有情绪障碍的儿童和青少年及其家庭。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790502

B A Stroul, S A Pires, L Roebuck, R M Friedman, B Barrett, K L Chambers, M A Kershaw

{"title":"State health care reforms: how they affect children and adolescents with emotional disorders and their families.","authors":"B A Stroul, S A Pires, L Roebuck, R M Friedman, B Barrett, K L Chambers, M A Kershaw","doi":"10.1007/BF02790502","DOIUrl":"https://doi.org/10.1007/BF02790502","url":null,"abstract":"This article reports on the Health Care Reform Tracking Project, a national study designed to describe and analyze state health care reforms and their impact on children and adolescents with emotional disorders and their families. It summarizes the results of the baseline survey of states conducted in 1995, exploring the nature and extent of the reforms in which states are engaged, most of which involve applying managed care technologies to their Medicaid programs. Trends across states are identified with respect to mental health service delivery, particularly with respect to children and adolescents. The article concludes with a discussion of issues and concerns related not only to mental health service delivery for children and adolescents with emotional disorders and their families but also to the systems of care that have been developing over the past decade to serve them. Some of these concerns include the lack of pilots or demonstrations, limited mental health coverage in some reforms, the lack of integration between mental health and substance abuse systems, the lack of special provisions for children, the need for more reliable bases for deriving capitation rates, the limited incorporation of systems of care, the need to incorporate interagency treatment planning and service delivery approaches, the lack of outcome measures specific to and appropriate for children, and the need for greater family involvement in the planning and implementation of these reforms.","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"24 4","pages":"386-99"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20296540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Sedative-hypnotic use by the elderly: effects on hospital length of stay and costs. 老年人使用镇静催眠药：对住院时间和费用的影响。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790484

E J Yuen, M H Zisselman, D Z Louis, B W Rovner

{"title":"Sedative-hypnotic use by the elderly: effects on hospital length of stay and costs.","authors":"E J Yuen, M H Zisselman, D Z Louis, B W Rovner","doi":"10.1007/BF02790484","DOIUrl":"10.1007/BF02790484","url":null,"abstract":"Sedative-hypnotic medications are often used to treat anxiety and sleep disorders, although they may not be used appropriately. Relationships between hospital length of stay (LOS), costs, and levels of sedative-hypnotic use were examined. Charts of 856 elderly patients were reviewed for sedative hypnotic use and categorized into three groups: those whose use exceeded Health Care Financing Administration (HCFA) guidelines, those who used sedative-hypnotic medications but did not exceed HCFA guidelines, and those who did not receive any sedative-hypnotic medications. Patients whose sedative-hypnotic use exceeded guidelines had longer LOS (21.5 exceeding guidelines vs. 12.3 within guidelines vs. 6.7 no use, p < or = .001) and higher costs ($29,245 exceeding guidelines vs. $15,219 within guidelines vs. $7,516 no use, p < = or .001.) Even after controlling for severity of illness and comorbid conditions, differences in LOS and costs persisted. This study indicates that sedative-hypnotic medications are frequently prescribed to elderly patients, often in doses exceeding proposed guidelines, and are associated with longer hospital stays and higher hospital costs.","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"24 1","pages":"90-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19989966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Policy-relevant program evaluation in a national substance abuse treatment system. 国家药物滥用治疗系统中与政策相关的项目评估。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790501

K Humphreys, E G Hamilton, R H Moos, R T Suchinsky

{"title":"Policy-relevant program evaluation in a national substance abuse treatment system.","authors":"K Humphreys, E G Hamilton, R H Moos, R T Suchinsky","doi":"10.1007/BF02790501","DOIUrl":"10.1007/BF02790501","url":null,"abstract":"This article discusses recent trends in public and private substance abuse services and offers suggestions on how the evaluation of such services can inform clinical practice and policy making. This analysis focuses particularly on the Department of Veterans Affairs (VA), which operates the largest substance abuse treatment system in the United States. In recent years, there has been an erosion of services for substance abuse outside the VA. In contrast, due to increased funding from the U.S. Congress, the VA significantly expanded substance abuse treatment from 1990 to 1994. However, efforts to \"reinvent\" and downsize government initiated a reversal of this growth trend in 1994, and VA services may shrink further as the system becomes more decentralized and adopts managed care strategies from the private sector. Drawing from the VA Program Evaluation and Resource Center's (PERC) experience of evaluating the VA system and working with federal policy makers, this article presents examples and suggestions for making evaluations of substance abuse treatment systems more useful in policy discussions and in day-to-day clinical practice.","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"24 4","pages":"373-85"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20296539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Residency training in Massachusetts: a new approach to state-university collaboration. 马萨诸塞州住院医师培训:州立大学合作的新途径。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790486

M A Hanson, E L Stone, R B Flannery

{"title":"Residency training in Massachusetts: a new approach to state-university collaboration.","authors":"M A Hanson, E L Stone, R B Flannery","doi":"10.1007/BF02790486","DOIUrl":"https://doi.org/10.1007/BF02790486","url":null,"abstract":"Traditional state-university collaborations, known as public-academic liaisons (PALs), have resulted in improved quality of service and enhanced residency training. Recent national trends for treating persons with serious mental illness, including moving services from institutional settings to community-based care and emphasizing the use of rehabilitative approaches as well as changes in the health care delivery system itself, have led to preliminary rethinking of some discrete aspects of more traditional approaches. Rather than discrete changes, Massachusetts has responded to these emerging trends with a new and comprehensive initiative that emphasizes one set of statewide standards in these emerging content areas for all residency training programs. Consistent with new practices in health care delivery, this new initiative was fielded through a process of competitive bidding rather than through traditional allocation of service positions. The development, implementation, and initial outcomes of this new approach are presented and implications for mental health administrators are discussed.","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"24 1","pages":"103-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9472178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Children's mental health in a continuum of care: clinical outcomes at 18 months for the Fort Bragg demonstration. 连续护理中的儿童心理健康:布拉格堡示范18个月的临床结果。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790507

K M Hamner, E W Lambert, L Bickman

引用次数: 11

The relationship of patient-administered outcome assessments to quality of life and physician ratings: validity of the BASIS-32. 患者管理的结果评估与生活质量和医生评分的关系:BASIS-32的有效性。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02898514

J Russo, P Roy-Byrne, C Jaffe, R Ries, C Dagadakis, E Dwyer-O'Connor, D Reeder

{"title":"The relationship of patient-administered outcome assessments to quality of life and physician ratings: validity of the BASIS-32.","authors":"J Russo, P Roy-Byrne, C Jaffe, R Ries, C Dagadakis, E Dwyer-O'Connor, D Reeder","doi":"10.1007/BF02898514","DOIUrl":"https://doi.org/10.1007/BF02898514","url":null,"abstract":"The reliability and validity of a patient-administered version of the Behavior and Symptom Identification Scale (BASIS-32) was compared to the original interviewer-administered version. The construct validity of BASIS-32 subscales was assessed by examining their relationship with functional and satisfaction quality of life and physician ratings of functional and clinical status. A total of 361 acute psychiatric inpatients were given a self-administered BASIS-32, nurse-administered Lehman's Quality of Life Interview (QOLI), and Psychiatrist Assessment Form at admission and discharge. The original factor structure, internal consistency reliability, discriminant validity, and sensitivity to change were replicated. The patient-administered BASIS-32 is equally as reliable and valid as the interview. Construct validity analyses revealed that functional and satisfaction QOLI indices were moderately related to the BASIS-32 in the hypothesized directions. All satisfaction scales were associated with significantly less severity. Physician ratings were only mildly related to the subscales. The BASIS-32 used in outcome assessments with inpatients provides important and unique perspectives on functional and clinical status that are not tapped by clinician-rated assessments.","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"24 2","pages":"200-14"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02898514","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20059983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

Services for clients of community support programs in rural Wisconsin. 为威斯康星州农村社区支持项目的客户提供服务。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790480

E J Hollingsworth

引用次数: 0

Program environments of self-help agencies for persons with mental disabilities. 智障人士自助机构的项目环境。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790506

S P Segal, C Silverman, T Temkin

引用次数: 7

Evaluating performance and change in mental health systems serving children and youth: an interorganizational network approach. 评估为儿童和青少年服务的精神卫生系统的表现和变化:组织间网络方法。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790476

J P Morrissey, M C Johnsen, M O Calloway

{"title":"Evaluating performance and change in mental health systems serving children and youth: an interorganizational network approach.","authors":"J P Morrissey, M C Johnsen, M O Calloway","doi":"10.1007/BF02790476","DOIUrl":"https://doi.org/10.1007/BF02790476","url":null,"abstract":"Planning for the delivery of community mental health services has evolved from models of services within individual agencies to community-wide systems of care, but development of methodologies for assessing system performance has lagged behind. This article presents one approach to system-level assessment by viewing children's mental health systems as an interorganizational network. Data are presented on two county-based child mental health systems in North Carolina that participated in the Robert Wood Johnson Foundation Mental Health Services Program for Youth. Site-specific data on client referrals, fund exchanges, and information flows were collected at two time points (1991 and 1993) to measure the cohesiveness and concentration of the service system using network k-core analyses. In addition, stakeholder ratings of service adequacy, quality, availability, coordination, and overall demonstration project goal attainment were obtained at both time periods. Findings indicate that the rural system was outperforming the urban system at the time of the first survey, but the urban system caught up over the study interval. There was high agreement between the network and stakeholder ratings of system performance at both time periods. The method of data collection and analysis used in this study provides tools that can be used in a variety of settings to assess service system growth and development.","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":"24 1","pages":"4-22"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 40

The appropriate role for the state hospital. 公立医院的适当作用。

Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790481

J R Belcher, B R DeForge

引用次数: 6