PubMed · 10145818
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J L Horowitz. 1993. Contribution margin analysis: a case study.. https://pubmed.ncbi.nlm.nih.gov/10145818/
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Physician turnover has long been a problem in community mental health centers. While explanations for the problem have been offered, there have been no systematic studies of factors associated with the high turnover. In this study, the Minnesota Satisfaction Questionnaire and the Organizational Commitment Questionnaire were given to psychiatrists employed by a community mental health center. Subjects were also asked to identify their treatment ideology, and to rate their perception of the ideology of other clinicians and administrators with whom they work. Psychiatrists perceived significant differences in many ideological areas. Analysis demonstrated a correlation between these differences and the commitment of the psychiatrists to the organization.
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The purpose was to show the changes taking place in a community mental health centre where the need for treatment definitely increased compared to the available resources. The reason for this was an increase in size of the district covered. Data was recorded in a database. All patients in treatment and received during the years 1994 and 1995 were registered. The years 1990-92 were used for comparison. The necessary changes in organisation are described. The number of patients received decreased and the percentage with serious mental illness increased. After visitation the population which received treatment at the centre was dominated by patients with chronic psychosis. More consultations were given in the patients' homes. The retention of patients decreased. It is concluded that only half of the people in the district with serious mental illness were receiving treatment and only by increasing the amount of staff would it be possible to get the rest into treatment. The intake of other diagnostic groups should only be discussed after these steps are taken.