title: Correlates of family burden under medicaid managed mental health care.
abstract: This study examined predictors of family burden (assistance in daily living, supervision, and subjective concern) for family members of Medicaid recipients with severe mental illness in two regions of Virginia. In the Richmond area, mental health services were provided on a no-risk fee-for-service basis, while in Tidewater these services were provided through a risk-based capitated contract with a managed care organization. No differences in family burden were attributable to the risk-based payment system. Predictors of increased family burden were (a) more reported client symptoms and disruptive behaviors, (b) status as a parent, and (c) living with the client.
authors.affiliation: Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, 27599-7160, USA. scott_stroup@med.unc.edu
authors.forename: T S
authors.initials: TS
authors.lastname: Stroup
authors.forename: J P
authors.initials: JP
authors.lastname: Morrissey
authors.forename: A R
authors.initials: AR
authors.lastname: Ellis
authors.forename: M
authors.initials: M
authors.lastname: Blank
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002204:Capitation Fee; D017028:Caregivers; D017281:Cost of Illness; D018588:Fee-for-Service Plans / Q000191:economics; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008484:Medicaid / Q000458:organization & administration*; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration*; D008875:Middle Aged; D012044:Regression Analysis; D020414:Risk Sharing, Financial; D014481:United States; D014768:Virginia