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  1. Is there an increased clinical severity of patients with eating disorders under managed care ?

    Article - En anglais

    Objectives 

    We sought to examine possible differences in medical status at presentation in 1996, compared to 1991, of adolescents with eating disorders (EDs) at a hospital-based multidisciplinary care program to reflect the increasing market penetration of managed care.

    Design 

    Charts were reviewed for all new patients scheduled in a hospital-based outpatient ED program in 1996 and 1991.

    The 92-item standardized data extraction form included information on demographics, indicators of illness severity at the first visit, and subsequent hospitalization.

    The need for primary care referral was verified using billing records.

    Data were analyzed with Student's t-test, Chi-square, Fisher's exact, and Mann-Whitney U tests using SPSS 7.5. Results : Of the 153 total patients, 133 kept their intake appointment and 130 (98%) of these had charts available for review.

    The age, racial/ethnic characteristics, and average length of disordered eating behaviors were not significantly different over the 5-year period.

    Referral from a primary care clinician was more commonly required in 1996 than 1991 (59% vs. 11% ; p<. 0001).

    Eighteen percent of the patients seen in 1996 were admitted from the initial appointment for medical stabilization, compared to 1.5% in 1991 (p=002).

    Comparing 1996 to 1991, a similar number of patients had symptoms consistent with anorexia nervosa, whereas fewer patients in 1996 gave a history of bingeing and purging (22% vs. 40% ; p=027). (...)

    Mots-clés Pascal : Trouble comportement alimentaire, Traitement, Système santé, Soin intégré, Etats Unis, Amérique du Nord, Amérique, Organisation santé, Santé mentale, Adolescent, Homme

    Mots-clés Pascal anglais : Eating disorder, Treatment, Health system, Managed care, United States, North America, America, Public health organization, Mental health, Adolescent, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0390711

    Code Inist : 002B18H05B. Création : 22/03/2000.