title: Psychiatric hospital length of stay for Medicaid clients before and after managed care.
abstract: Managed care systems allegedly discharge psychiatric inpatients "quicker and sicker" than fee-for-service programs. Study subjects were admitted to a general hospital that served adjacent counties. During 1994, both counties operated fee-for-service Medicaid mental health systems. In 1995, one county remained fee-for-service and the other assumed inpatient financial risk. Lengths of stay declined in both counties between 1994 and 1996. Managed care patients had longer lengths of stay than their fee-for-service counterparts (even after adjustment for confounders). Secular trends and practice patterns may influence length of stay more than managed care.
authors.affiliation: Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland 97201, USA. mcfarlab@ohsu.edu
authors.forename: Bentson H
authors.initials: BH
authors.lastname: McFarland
authors.forename: Suzann
authors.initials: S
authors.lastname: Khorramzadeh
authors.forename: Rebecca
authors.initials: R
authors.lastname: Millius
authors.forename: Jo
authors.initials: J
authors.lastname: Mahler
mesh_terms: D000328:Adult; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006778:Hospitals, Psychiatric / Q000191:economics / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data*; D009922:Oregon