Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Insurance, Psychiatric”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,189 records · Page 66Linked to original sources
PubMed1997

[More of the Surinam and Antilles drug addicts involved in the GG&GD (Community Medical and Health Service) methadone program in Amsterdam should be referred to the family physician for their methadone maintenance].

OBJECTIVE: To study the possibility of referring Surinam and Netherlands Antillean drug users from a 'low-threshold' municipal methadone programme to general practice for methadone maintenance treatment. (Methadone maintenance treatment for drug users leads to a more regulated life and makes it possible to implement measures to ameliorate their living conditions.) Fewer Surinam and Netherlands Antillean drug users are referred to general practice than native Dutch drug users. DESIGN: Descriptive. SETTING: Municipal Health Service, Department of Mental Health, Unit on Drugs, Amsterdam, the Netherlands. METHOD: 141 Surinam and Netherlands Antillean drug users participating in the 'low-threshold' methadone programme were examined on the following items: psychiatric status, drug and alcohol abuse, judicial problems, relationships, personal care, insurance and housing. With these items the level of regulated drug use was assessed and the possible reference to general practice evaluated. RESULTS: 21% of the drugs user group was found to be well regulated. They could have been referred to general practice immediately. Another 18% were also well regulated but they received methadone on a daily basis at the moment of investigation; when they would have proven to manage methadone prescription on a weekly basis, they could also be referred to general practice. 61% could not be referred because they were addicted to benzodiazepines (22%) or alcohol (33%), lived in unsuitable housing (45%), had judicial problems (53%), psychiatric problems (30%) or no insurance (15%), or were very problematic drug users receiving Palfium (dextromoramide) through the 'low-threshold' municipal methadone programme (15%). CONCLUSION: Of Surinam and Netherlands Antillean drug users from a municipal methadone programme, approximately 20% could have been directly referred to general practice for their methadone maintenance treatment and 20% at a later stage, and 60% could not.

Adult↗
PubMed1987

Differences in resource use and cost among facilities treating alcohol, drug abuse, and mental disorders: implications for design of a prospective payment system.

Specialized psychiatric facilities, including qualified distinct-part units in general hospitals, are exempt from Medicare's diagnosis-related group prospective payment system (PPS). One major reason for continuing the exemption is the redistribution of revenue that would probably occur if a single national price were established for care at the diverse facilities that treat patients with psychiatric and substance abuse disorders. This study investigated the extent of such potential redistribution in a private health insurance data base and found that a PPS would systematically underpay specialized facilities and systematically overpay general hospitals without specialized units. Alternatives for addressing this problem are discussed.

Alcoholism↗
PubMed1996

Medicare's mental health benefits: coverage, use, and expenditures.

Estimates of the proportion of persons aged 65 and older with diagnosable mental disorders, residing both in the community and in institutions, range from 13.5% to 22%. Mental health services, both inpatient and outpatient, short and long term, are necessary for the well-being of these older Americans. Mental health benefits are covered under Medicare. However, less than 3% of the $90.5 billion Medicare budget in 1988 was spent on mental health services. Of that 3%, $2.2 billion was used for Part A (hospital insurance) and $300 million for Part B (medical insurance). In contrast, in the same year, payments for mental health services represented 20% to 30% of total health expenditures made by private insurers. Differences in payments abound when comparing freestanding psychiatric facilities with both exempt and nonexempt psychiatric units in general hospitals. This article describes these differences and how they influence the use of mental health services by Medicare beneficiaries.

Aged↗
PubMed1979

Psychiatric illness among adults adopted as infants.

In an epidemiological study of 2,323 adopted adults, the registrations about sick-leave, diagnoses and hospitalization (F-cards) from the National Health Insurance were studied. There was a significantly higher frequency of psychiatric illness among the adoptees compared with non-adopted controls. A classification into different diagnostic groups from the records of psychiatric hospitals showed an over-representation due to alcohol and drug abuse and personality disorders in both male and female adoptee groups compared with non-adopted controls. There was also an over-representation in the male adoptee group due to neuroses.

Absenteeism↗
PubMed1999

Changes in inpatient mental health utilization and costs in a privately insured population, 1993 to 1995.

BACKGROUND: Concerns over rising health care costs have led to pressure on health care providers to reduce inpatient costs. METHODS: Inpatient claims data were analyzed for adult users of mental health services (n = 45,579) from a national sample of over 3.8 million privately insured individuals between 1993 and 1995 from the MarketScan database. Costs and annual hospital days per treated patient were compared across diagnostic groups and plan types. RESULTS: Inpatient mental health costs fell 30.5% over the period, driven primarily by decreases in the number of hospital days per treated patient per year (-20.0%), with smaller changes in the proportion of enrollees who received care (-0.2%), and per diem costs (-13.1%). Patients whose primary diagnosis was mild/moderate depression saw the largest decrease in costs per treated patient (44.5%), and those diagnosed with schizophrenia experienced the smallest decrease (23.5%). There was no evidence of substitution of medical for psychiatric care. CONCLUSIONS: Inpatient cost reductions have been substantial and are primarily caused by reductions in the number of inpatient mental health treatment days per treated patient. Further research is needed to evaluate the impact of these changes on outcome, quality of care, and patient satisfaction.

Adult↗
PubMed2001

Impact of DNA testing for early-onset familial Alzheimer disease and frontotemporal dementia.

BACKGROUND: DNA testing of persons at risk for hereditary, degenerative neurologic diseases is relatively new. Only anecdotal reports of such testing in familial Alzheimer disease (FAD) exist, and little is know about the personal and social impact of such testing. METHODS: In a descriptive, observational study, individuals at 50% risk for autosomal dominant, early-onset FAD or frontotemporal dementia with parkinsonism linked to chromosome 17 underwent DNA testing for the genetic mutations previously identified in affected family members. Individuals were followed up for (1/2) to 3 years and were interviewed regarding attitudes toward the testing process and the impact of the results. RESULTS: Twenty-one (8.4%) of 251 persons at risk for FAD or frontotemporal dementia requested genetic testing. The most common reasons for requesting testing were concern about early symptoms of dementia, financial or family planning, and relief from anxiety. Twelve individuals had positive DNA test results, and 6 of these had early symptoms of dementia; 8 had negative results; and 1 has not yet received results. Of 14 asymptomatic individuals completing testing, 13 believed the testing was beneficial. Two persons reported moderate anxiety and 1 reported moderate depression. As expected, persons with negative test results had happier experiences overall, but even they had to deal with ongoing anxiety and depression. Thus far, there have been no psychiatric hospitalizations, suicide attempts, or denials of insurance. CONCLUSIONS: Genetic testing in early-onset FAD and frontotemporal dementia can be completed successfully. Most individuals demonstrate effective coping skills and find the testing to be beneficial, but long-term effects remain unknown.

Adult↗
PubMed1997

The impact of psychiatric disorders on work loss days.

BACKGROUND: To examine relationships between recent DSM-III-R psychiatric disorders and work impairment in major occupational groups in the US labour force. METHOD: Data are from the US National Comorbidity Survey (NCS), a survey of respondents ages 15-54 in the US. Employed people are the focus of the report. RESULTS: There is substantial variation across occupations in the 30-day prevalences of NCS/ DSM-III-R psychiatric disorders, with an average prevalence of 18.2% (range: 11.0-29.6%) for any disorder. The average prevalences of psychiatric work loss days (6 days per month per 100 workers) and work cutback days (31 days per month per 100 workers), in comparison, do not differ significantly across occupations. Work impairment is more strongly concentrated among the 3.7% of the workforce with co-morbid psychiatric disorders (49 work loss days and 346 work cutback days per month per 100 workers) than the 14.5% with pure disorders (11 work loss days and 66 work cutback days per month per 100 workers) or the 81.8% with no disorder (2 work loss days and 11 work cutback days per month per 100 workers). The effects of psychiatric disorders on work loss are similar across all occupations, while effects on work cutback are greater among professional workers than those in other occupations. CONCLUSION: The results reported here suggest that work impairment is one of the adverse consequences of psychiatric disorders. The current policy debate concerning insurance coverage for mental disorders needs to take these consequences into consideration.

Absenteeism↗
PubMed1989

Opportunities and risks in Philadelphia's capitation financing of public psychiatric services.

The city of Philadelphia was one of nine sites selected by the Robert Wood Johnson (RWJ) Foundation and the U.S. Department of Housing and Urban Development (HUD) to receive five-year funding to improve the delivery, quality and cost efficiency of public mental health services to its chronically mentally ill population. As part of the RWJ project, the city plans to restructure its delivery and reimbursement system, creating a not-for-profit central authority which will function as a health insurance organization (HIO) responsible for coordinating and managing psychiatric care to Medicaid clients. Operating under a model of capitation, the central authority will employ diverse funding mechanisms to finance and manage service delivery. This paper examines the benefits and risks inherent in the reorganization of Philadelphia's mental health service system under a capitation financing model. Issues considered include cost and utilization patterns, treatment outcomes, providers and their staffing patterns, service mix and the overall impact of capitation on clients.

Capitation Fee↗
PubMed2006

[Social inequalities and access to health care: consequences of the revision of the Swiss insurance law (art 64A)].

The revision of the Swiss health insurance law (article 64A) excludes an increasing portion of the Swiss population from access to health care, and specifically to medications. From May to August 2006, 84 patients were referred to the University Hospital's primary care outpatient clinic to receive medications. These patients had a low socio-economic position, suffered from chronic diseases (88%) and had a high prevalence of psychiatric diseases (59%). This change in the Swiss insurance law mainly has an impact on the more fragile members of society and threatens the concept of equal access of the whole population to the national health care system.

Health Services Accessibility↗
PubMed1986

Suicide and attempted suicide: legal issues.

Canadian Federal and Ontario Provincial statutes are reviewed as they relate to suicide and attempted suicide. Issues addressed include involuntary committal to psychiatric facilities, death by suicide as a legal cause of action, insurance exclusionary clauses and coroner's inquests.

Adult↗