Managing the care of schizophrenia : Lessons from a 4-year Massachusetts Medicaid study.
In 1992, Massachusetts launched a state-wide managed care plan for all Medicaid beneficiaries.
This retrospective, multiyear, cross-sectional study used administrative data from the Massachusetts Division of Medical Assistance and Department of Mental Health, consisting of claims for 16 400 disabled adult patients insured by Medicaid in Massachusetts between July 1,1990, and June 30,1994.
The main outcome measures include annual rates of hospitalization, emergency department utilization, and follow-up care 30 days after discharge ; length of inpatient stay ; and per-person inpatient and outpatient expenditures.
Between 1991 and 1994, the likelihood of an inpatient admission decreased from 29% to 24% and was accompanied by a slight reduction in length of stay (median number of bed-days per admission dropped by 3.3 days).
There was a slight decrease in the number of patients who sought care in general hospital emergency department utilization.
However, there was a small increase in the fraction of patients readmitted within 30 days of discharge.
Medicaid and Department of Mental Health expenditures for mental health per treated beneficiary decreased slightly, from $11 060 to $10 640, during the 4-year study period.
Although per-person expenditures dropped and most patient patterns of care remained the same, longer-term study is recommended to assess whether the trends can be maintained.
Mots-clés Pascal : Schizophrénie, Psychose, Système santé, Massachusetts, Etats Unis, Amérique du Nord, Amérique, Etude longitudinale, Utilisation, Service santé, Durée, Hospitalisation, Organisation santé, Accessibilité, Soin, Homme, Medicaid, Continuité soins, Soins intégrés
Mots-clés Pascal anglais : Schizophrenia, Psychosis, Health system, Massachusetts, United States, North America, America, Follow up study, Use, Health service, Duration, Hospitalization, Public health organization, Accessibility, Care, Human, Managed care
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0473693
Code Inist : 002B18H05B. Création : 10/04/1997.