Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:dateCreated
2003-12-18
pubmed:abstractText
Restricted access to health care services and medication is associated with overall higher utilization and higher health care costs. Although randomized controlled trials (RCTs) are regarded as the best method of determining whether a treatment strategy does more good than harm, clinical practice improvement (CPI) methods may be a more effective way of achieving superior medical outcomes for the least cost over the course of a patient's care. The Managed Care Outcomes Project, a large-scale CPI study, tracked detailed factors regarding medical care, patients, and outcomes from different managed care settings. Results showed that cost-containment strategies employed by various health maintenance organizations were associated with poor treatment outcomes for patients and in fact increased total health care costs. Psychiatric illnesses were underdiagnosed, and care ranged from patients receiving psychiatric medications without a psychiatric diagnosis to patients with a psychiatric diagnosis receiving no psychiatric treatment at all. Cost-containment strategies appeared to limit psychiatric referrals, frequency of psychiatric visits, and use of certain antidepressants (i.e., selective serotonin reuptake inhibitors). Further, the severity of the primary physical illness in the study population was associated with greater psychiatric illness. The fact that treatment was inconsistent and frequently inappropriate shows the need for better diagnostic and management protocols.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
0160-6689
pubmed:author
pubmed:issnType
Print
pubmed:volume
64 Suppl 17
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
23-8
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:14680424-Antipsychotic Agents, pubmed-meshheading:14680424-Cost Control, pubmed-meshheading:14680424-Diagnostic Errors, pubmed-meshheading:14680424-Drug Utilization, pubmed-meshheading:14680424-Health Care Costs, pubmed-meshheading:14680424-Health Maintenance Organizations, pubmed-meshheading:14680424-Health Services Accessibility, pubmed-meshheading:14680424-Humans, pubmed-meshheading:14680424-Mental Disorders, pubmed-meshheading:14680424-Mental Health Services, pubmed-meshheading:14680424-Outcome and Process Assessment (Health Care), pubmed-meshheading:14680424-Physician's Practice Patterns, pubmed-meshheading:14680424-Primary Health Care, pubmed-meshheading:14680424-Psychiatry, pubmed-meshheading:14680424-Randomized Controlled Trials as Topic, pubmed-meshheading:14680424-Referral and Consultation, pubmed-meshheading:14680424-United States
pubmed:year
2003
pubmed:articleTitle
Limiting access to psychiatric services can increase total health care costs.
pubmed:affiliation
Institute for Clinical Outcomes Research, International Severity Information Systems, Inc., and the University of Utah School of Medicine, Salt Lake City, UT 84102-1282, USA. shorn@isisicor.com
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't