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 1,243 records · Page 69Linked to original sources
PubMed1995

Goods on which one loses: women and mental health in China.

This article is broadly divided into three sections. The first part deals with the traditional aspects of gender discrimination in China. Before the Communist government came to power in 1949, discrimination against women was institutionalized within all the usual structures of society: family, the economy, education, culture and the political system. It was one of the major policy initiatives of the Communist government to do away with unequal treatment of women. However, it is very easy to demonstrate that significant discrimination against women still exists. The Chinese government argues that this is because of 'remnants of feudal thinking'. Although this may be partly true, there are aspects of current Chinese society that encourage the continuation of this cultural tradition. The second part of the article examines what is known of the epidemiology of mental illness in China with particular reference to gender. As is the case in Western countries, depression and neurotic disorders are diagnosed more frequently in women than in men, although, overall, the prevalence rate is much lower than in Western countries. What is unusual is that schizophrenia, which is diagnosed at roughly equal rates for men and women in Western countries, is diagnosed more frequently in women in China. Despite this, women occupy fewer psychiatric hospital beds and generally receive fewer resources (e.g. health insurance) than men. Suicide rates are very much higher in China than, for instance, in America, and the suicide figures for young, rural women are particularly disturbing. The third part of the article is based on three interviews with women in a psychiatric clinic in Hubei province.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Psychiatric malpractice due to ignorance. Reports of cases of psychiatric treatment and traumatic neurosis handled by the doctor's liability board in which damages have been claimed.

During the last 15 years, the Finnish insurance companies' doctor's liability board has handled six cases in which damages were claimed for psychiatric treatment or traumatic neuroses. Reports of these cases, grouped according to basis of indemnification, are given above. The board considered two of the claims unjustified and four justified. The party liable for damages was, in every case, the hospital. In Finland, claims for damages lodged with hospitals and doctors have not been very common. This is partly due to Finnish legislation. Claims for damages arising from psychiatric treatment are rare. In Finland, the party primarily responsible for injury to a patient is the employer (e.g. a hospital) and only secondly an employee. In practice, it is rare for a doctor to be required to pay damages for malpractice or neglect.

Expert Testimony↗
PubMed1995

Mental health and choice between managed care and indemnity health insurance.

OBJECTIVE: Populations enrolled in various health insurance plans may differ in their health care needs. Whether mental health affects choice among competing health plans is not clear. This study examined self-selection by participants in a Swiss indemnity insurance plan that was transformed into a managed care organization that controlled access to specialists through gatekeeping and restricted coverage for psychiatric treatments. METHOD: Information regarding past use of health services and health status was provided by 421 persons who joined the new managed care organization and 222 nonjoiners. The mental health and somatic health characteristics of these two groups were compared. RESULTS: In the year preceding the creation of the managed care organization, the nonjoiners had made on average 2.3 more visits to psychiatrists than the joiners but 0.0 to 0.6 more visits to other physicians. The nonjoiners were more likely to have used psychoactive medications but not other medications. The rates of treatment for depression were similar in the two groups. The joiners reported significantly lower mental health status, but not somatic health status, than the nonjoiners. CONCLUSIONS: Both mental health status and past use of mental health services strongly affected choice of health insurance plan. The effects of somatic health and use of somatic health services on selection were consistently weaker. People who join managed care organizations may have substantial uncovered needs for psychiatric care. Minimum mandatory benefits for mental health care may be an effective countermeasure to unequitable self-selection.

Adolescent↗
PubMed1994

Screening for psychiatric illness in primary care. A cross-sectional study in a Swedish health district.

A sample of 388 primary care patients in a Swedish health district were screened for psychiatric illness using the Hopkins Symptom Check List HSCL-25. General practitioner (GP) ratings of psychiatric illness and patient ratings of psychosocial problems were also included. Data concerning the patients' utilization of care and health insurance were recorded. According to the HSCL-25, 30.2% of the patients were probable psychiatric cases and 19.2% were psychiatric cases in need of treatment. According to GPs' independent ratings, 12.3% of the patients suffered from psychiatric illness requiring treatment. Psychiatric cases according to HSCL-25 were more often women, divorced, unemployed and living alone. During the year preceding index contact, psychiatric cases showed a higher utilization of primary care, as well as other somatic care. They also had more sick leave. Psychiatric cases perceived higher levels of psychosocial problems in areas of unemployment, work situation, private economy, child care and social isolation. The results of the study point to the interaction of psychological impairment, environmental stress and lack of social support in producing psychiatric illness.

Adolescent↗
PubMed1989

[Is the suicidal person in the act of suicide in control? Forensic insurance considerations of a new explanatory medical model].

On the basis of extensive psychiatric research into suicide in the Province of Salzburg five stages of suicidal development are initially described: 1) consideration; 2) ambivalence; 3) decision; 4) intention; 5) completion of the action. Whereas in the first three stages both the ability to see reason and to control himself can be unaffected, in the act of self-destruction (stage 4 and 5) the suicide is in principle unable to control himself, whereby the ability to see reason may largely be maintained. This new medical model to explain suicide is discussed with regard to the law of insurance. An attempt is made to provide medical and legal aid for assessors and users of the law.

Austria↗
PubMed1996

[Duration of treatment and case cost in different inpatient psychiatric facilities in Berlin].

In this study length of stay and costs per case were examined in three different types of psychiatric hospitals: Psychiatric departments in general hospitals and psychiatric hospitals each liable to provide in-patient care for a defined catchment area, and psychiatric departments in general hospitals without such liability. Data basis were all hospital treated cases in Berlin West that are covered by general insurance. Length of stay and costs differed significantly depending on the type of psychiatric hospital as well as on diagnoses, way of referral and age of patients. Psychiatric departments with catchment area have the shortest length of stay and lowest costs per case. This is independent of age, gender, way of referral and diagnosis of the patients. Influence of each factor is quantified.

Adolescent↗
PubMed2006

[Marginal case of a practice fee for psychiatric emergency service].

Since 1 January 2004, the German Act for the Modernisation of Health Insurance (GMG) has regulated collection of a so-called practice fee-a charge to patients for their first outpatient health care in any given quarter. We report the case of a slightly inebriated patient who, against his will, was taken to a psychiatric outpatient department by local authorities, where he had to pay the quarterly charge of 10 EUR. Considering that he was forced and therefore had to pay the fee against his will, the present regulation is being discussed with respect to legal and moral implications in psychiatric emergency cases.

Alcoholic Intoxication↗
PubMed2005

[Eating disorders (II)--dental aspects].

Patients suffering from eating disorders exhibit oral symptoms indicative to the otherwise concealed illness. The most striking features are the intrinsic erosions due to the regular surreptitious vomiting. They occur in very typical locations within the dental arches and have been termed "perimolysis". Dental professionals are often the first to discover and diagnose eating disorders by detecting perimolysis and consequently face the difficult task to motivate the patients--who often deny their illness--to seek psychiatric help and dental care. Such motivation must be done while respecting the patients' integrity and sense of self-worth. The primary goal of dental care is to preserve the remaining teeth and to prevent further erosive loss of dental hard tissue. The key elements of a dental preventive programme based on pathophysiologic grounds are to enhance local defence mechanisms, to offer chemical and mechanical protection and to diminish abrasive and erosive challenges. Dental restorative therapy must be part of a combined medical and dental treatment plan and should not be started before the eating disorder has been treated and the patients are considered to have stable prognosis. In view of the young age of the patients, the large extension of the erosive lesions and in order to avoid endodontological treatment of mostly sound pulps, non-invasive restorative concepts using adhesive technology should be preferably used. Prophylactic measures and restorative treatment are covered by health insurance (KGV; KLV 18c, 7) if the patients undergo psychiatric or similar adequate treatment.

Adolescent↗
PubMed2007

[Self-mutilation from a forensic medicine viewpoint].

The frequency of the diagnosis of self-induced injuries is rising, especially in patients with borderline personality disorder. The number of unreported cases is estimated to be high. Self-mutilation typically affects the patient's skin and therefore often presents to dermatologists or general practitioners. Such injuries are often clinically typical; a knowledge of these features is essential for the correct diagnosis and treatment. Multidisciplinary care is essential because of the tendency for overlap with other psychiatric diseases and the risk of suicide. Self-induced injuries are also used to simulate criminal offences and to fraudulently obtain insurance payments. In these cases appropriate diagnosis is important from both a legal and psychiatric point of view. Typical morphological aspects and combination of clinical signs in cases of self-mutilation are presented from forensic point of view to facilitate confirming the diagnosis.

Borderline Personality Disorder↗
PubMed2005

Mefloquine increases the risk of serious psychiatric events during travel abroad: a nationwide case-control study in the Netherlands.

BACKGROUND: Psychiatric events during travel abroad account for a large percentage of medical repatriations arranged by insurance companies. Several risk factors have been proposed for such events, one of these being use of mefloquine. We investigated the risk of psychiatric events during use of mefloquine. METHOD: We performed a nationwide case control study using medical records from 4 large alarm centers in the Netherlands. Cases were patients contacting the alarm centers because of psychiatric events, according to International Code Primary Care code P (all psychiatric symptoms) or International Classification of Diseases, Ninth Edition, codes 290-319 (all psychiatric syndromes). To every case we matched up to 6 controls by alarm center, calendar time, and continent of travel. All controls had contacted the alarm centers because of nonpsychiatric medical reasons. Shortly after the anticipated day of return, cases and controls received a questionnaire regarding travel characteristics, gender, age, marital status, education, weight, height, general health, history of psychiatric diseases, use of medicines, smoking status, alcohol intake, coffee intake, and use of malaria prophylaxis. Dates of travel for the source population were between September 1, 1997, and June 1, 2000. RESULTS: The study population consisted of 111 cases and 453 controls. The risk of psychiatric events during the use of mefloquine was 3.5 (95% CI = 1.4 to 8.7). In females, the risk was strongly increased, with an odds ratio of 47.1 (95% CI = 3.8 to 578.6). Stratification for history of psychiatric diseases showed that the risk of psychiatric events during use of mefloquine in cases without a history of psychiatric diseases was 3.8 (95% CI = 1.4 to 10.1), whereas the risk in cases with a history of psychiatric diseases was 8.0 (95% CI = 1.8 to 35.8). CONCLUSION: The use of mefloquine is associated with an increased risk of psychiatric events in females and in patients with a history of psychiatric diseases.

Adult↗
PubMed2004

Telepsychiatry with children and adolescents: are patients comparable to those evaluated in usual outpatient care?

Several studies have described successful applications of telepsychiatry with children and adolescents. However, there has been little examination of the populations served by telepsychiatry and the ability to evaluate youth accurately through this medium. In this article, we examined whether telepsychiatry patients are representative of those in usual outpatient care. Participants included 369 patients 3-19 years old evaluated at two clinics. A new telepsychiatry clinic (TPC) developed to provide services to under-served communities, and a child and adolescent psychiatric outpatient clinic (CAPOC) that served youth from predominantly metropolitan areas were included in the study. The telepsychiatry sites were linked using ISDN lines at 384 KB/sec. We examined these two samples regarding demographics, payor status, and diagnostic profiles. Results indicated that youth evaluated through the TPC were broadly comparable to youth evaluated in the CAPOC. Therefore, telepsychiatry appears to serve youth that are representative of those seeking psychiatric care, and it is not restricted to youth with no medical insurance or with selected diagnoses. The similarity of diagnoses further suggests that telepsychiatry provides adequate technical resolution and doctor-patient rapport to detect psychopathology of youths. These findings suggest the need for further systematic investigation of telepsychiatry as a tool for providing psychiatric care to young people.

Adolescent↗
PubMed1998

Changing patterns of psychiatric inpatient care in the United States, 1988-1994.

Using data from the National Hospital Discharge Survey and the Inventory of Mental Health Organizations, this article examines national trends in psychiatric inpatient care from 1988 to 1994 in general hospitals and mental hospitals. We find that discharges with a primary diagnosis of mental illness in general hospitals increased from 1.4 to 1.9 million during this period. The total increase of 1.2 million days of care in general hospitals was small relative to the reduction of 12.5 million inpatient days in mental hospitals. General hospital discharges increased most in private nonprofit hospitals and declined substantially in public hospitals. Length of stay has fallen most substantially in private nonprofit hospitals. Public programs have increasingly replaced private insurance as the major source of payment. These observations suggest that psychiatric inpatient care in general hospitals can be characterized as a process in which patients who would have been clients of public mental hospitals in a prior period replace privately insured patients who, under managed care, are largely treated in community settings. Private nonprofit general hospitals increasingly treat publicly financed patients with more severe illnesses.

Episode of Care↗