title: Provider specialty choice among Medicare beneficiaries treated for psychiatric disorders.
abstract: This study estimates the probability of mental health specialist use among elderly and disabled Medicare beneficiaries treated for a primary psychiatric diagnosis, based on the 1991 Medicare Current Beneficiary Survey (MCBS) and physician claims. Beneficiaries with psychotic and affective disorders or multiple psychiatric diagnoses had a higher probability of specialty use, as did beneficiaries in counties with greater psychiatrist density. Elderly in counties with greater general practitioner density and disabled in counties with greater psychologist density were less likely to see a specialist, suggesting possible provider substitution. Government programs to recruit and retain mental health professionals in underserved areas may change provider specialty choices among Medicare beneficiaries treated for psychiatric disorders.
authors.affiliation: Harvard Medical School, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Ettner
authors.forename: R C
authors.initials: RC
authors.lastname: Hermann
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D006233:Persons with Disabilities; D005194:Family Practice; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D016345:Medicare Part B / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011570:Psychiatry; D011613:Psychotherapy; D012044:Regression Analysis; D012959:Socioeconomic Factors; D014481:United States