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Biomedical subjects

C A Taube

Publications and source records attributed to C A Taube.

At least 37 records · Page 2Linked to original sources
PubMed1986

Estimating the probability and level of ambulatory mental health services use.

Analysis of the National Medical Care Utilization and Expenditure Survey for persons with positive out-of-pocket expenses for one or more ambulatory mental health visits indicates that demand for such visits is responsive to price, and considerably more so than demand for health visits. Income, education, and insurance coverage interact in predicting demand, and price elasticity varies across income groups.

Age Factors↗
PubMed1985

Prospective payment and psychiatric discharges from general hospitals with and without psychiatric units.

For psychiatric patients treated in general hospitals, the prospective payment system does not differentiate between patients treated in medical-surgical wards and patients treated in psychiatric units. In particular, the system uses a single length-of-stay norm for both kinds of patients, even though psychiatric patients in medical-surgical units have shorter stays. The authors document major differences in length of stay and hospital charges for both groups of patients in relation to selected patient and hospital characteristics. They conclude that the current reimbursement procedures systematically overpay for stays in nonpsychiatric units and underpay for stays in psychiatric units, and they suggest mechanisms for partly reducing such inequities.

Adolescent↗
PubMed1984

Prospective payment for psychiatric hospitalization: questions and issues.

Can prospective payment control the cost of Medicare treatment without seriously affecting the quality of care? The authors pose this question and then explore the new system's implications for the mental health field. Because psychiatric diagnoses do not adequately describe the reasons for hospitalization, and because treatment of mental disorders is not standardized throughout the country, the authors posit that psychiatric hospitals will have difficulty adjusting to a reimbursement system based on diagnosis alone. They also review four major aspects of the prospective payment system: efficiency, equity and access for patients, quality of care, and practicality. Other issues, such as prospective payment's financial impact on medical research and technology development, are also discussed.

Cost Control↗
PubMed1983

The multiple functions of the state mental hospital.

This report identifies and quantifies the multiple manifest and latent functions of the state mental hospital, using data collected by the National Institute of Mental Health. The data reveal a complex institution providing over 500,000 episodes of care for acute and chronic, voluntarily and involuntarily admitted inpatients and 300,000 episodes of care for the most seriously disturbed and disadvantaged outpatients. In addition, state hospitals employ over 200,000 individuals and train over 3,300 professionals each year. The diversity and significance of these functions, as well as the failure of other institutions to supplant them, account for the endurance of the state mental hospital.

Commitment of Persons with Psychiatric Disorders↗
PubMed1983

Deinstitutionalization: the data demythologized.

Many past studies of data on deinstitutionalization have used an overly simplistic and often misleading approach, which has led to a number of "myths" of deinstitutionalization. The authors present data on the changing mental health service system collected by the Division of Biometry and Epidemiology of the National Institute of Mental Health, and they analyze the data to reveal trends that disprove a number of the commonly accepted myths. Through their analysis they show that outpatient care has not replaced inpatient care, that public institutions, particularly state mental hospitals, have not been replaced by community-based facilities, and that private resources have not replaced public ones as the bearer of the cost of caring for the mentally ill. They conclude that the availability and quality of mental health services and the effect of these services on patients and their communities are difficult issues for future research.

Community Mental Health Services↗
PubMed1983

The "chronic" mental hospital patient.

The rapid decrease in the resident population of state hospitals over the last decade has engendered a debate over the future role of the state hospital in the overall mental health services system. The authors report on a 1979 study of more than 2,000 state hospital patients designed to evaluate the characteristics of the current hospital population. Their findings document the existence of a new long-stay population that in many ways is similar to the old long-stay population that existed before deinstitutionalization. Continued hospitalization of the new population of long-stay patients, who now are younger than the old long-stay patient group, could cost more than $500 million dollars a year. The authors discuss the difficulty in predicting future trends from the existing data and outline four areas for future research.

Adolescent↗
PubMed1982

Reductions in insurance for mental disorders: adverse selection, moral hazard, and consumer demand.

Coverage for mental illness has been sharply reduced in the Federal Employees Health Benefits Program (FEHBP), especially in the largest of the participating plans, the Blue Cross and Blue Shield plan. The authors examine the role of adverse selection (accumulation of high-risk consumers within a given plan), moral hazard (demand for services for illness depending in part on the price of the services), and lack of overt consumer demand in the current trend. They point out the critical need for psychiatry to develop more effective approaches to public education on the nature of mental illness and its treatment. If the recent major cutbacks in the FEHBP prevail, this kind of restriction is likely to become the prevailing mode of mental illness coverage under private health insurance.

Blue Cross Blue Shield Insurance Plans↗
PubMed1981

Defining and counting the chronically mentally ill.

The shifts in the pattern and locus of mental health care arising from the deinstitutionalization movement have resulted in a lack of definitive information on the scope of the problem of chronic mental illness. In addition, there is a lack of consensus on the boundaries that define the chronically mentally ill population, boundaries that can guide national policy-makers in a more scientific assessment of needs. In a national study following up the recommendations of the President's Commission on Mental Health, the authors developed a detailed definition of the chronically mentally ill population based on diagnosis, disability, duration of illness, and the institutional and community settings in which chronic mental patients may be found. They used prevalence data from a number of sources to arrive at a national estimate of between 1.7 million and 2.4 million in the target population, including 900,000 in institutions.

Chronic Disease↗
PubMed1980

Community mental health centers and the treatment of severe mental disorder.

Between 1970 and 1975 the number and rate of admissions to community mental health centers of people given a diagnosis of schizophrenia increased dramatically. However, the proportion of patients with schizophrenia admitted to community mental health centers declined because the increase in the rate of admissions of patients with schizophrenia was diluted by the large increase in the rate of admissions of patients with other diagnoses. The authors review the data on trends in admissions of patients with a diagnosis of schizophrenia in the context of an expanding system of mental health services characterized by changes in the locus of care.

Acute Disease↗
PubMed1978

The de facto US mental health services system: a public health perspective.

The President's Commission on Mental Health has highlighted a heretofore unmet need for the linkage of data on the prevalence of mental disorder with national data on the use of mental health services. This study analyzes available epidemiological data and recent mental health services research findings to estimate the percent of the population with a mental disorder and the proportion utilizing various types of specialty mental health and general medical treatment settings. Provisional estimates indicate that at least 15% of the US population is affected by mental disorders in one year. In 1975, only one fifth of these were served in the specialty mental health sector, with about three fifths identified in the general medical (primary care) sector.

Commission on Professional and Hospital Activities↗
PubMed1977

Problems in analyzing the comparative costs of private versus public psychiatric care.

The authors outline the difficulties in attempting to compare the costs of service in various mental health settings, especially private practice and community mental health centers. Contributing to the difficulties are the differences in the populations served, differences in treatment modalities employed, and the different economic incentives operating in each setting. The authors stress the need for research on cost effectiveness as the basis for valid comparisons of various care settings.

Community Mental Health Services↗
PubMed1976

A quarter century of psychiatric care, 1950-1974: a statistical review.

The authors describe the changing trends in psychiatric care over the last quarter century. Whereas in 1950 state and county mental hospitals were the principal site for psychiatric care, by 1974 community mental health centers and other types of mental health facilities had an important role in providing such care. There has been a marked shift from inpatient to outpatient care, and more individuals with diagnoses other than psychoses are being treated today.

Adult↗