An agency-based representative payee program and improved community tenure of persons with mental illness
An agency-based representative payee program and improved community tenure of persons with mental illness
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DOI：
10.1176/ps.49.9.1218
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发表时间：
1998-09-01
影响因子：
3.8
通讯作者：
Shinderman, M
中科院分区：
文献类型：
--
作者：
Luchins, DJ;Hanrahan, P;Shinderman, M
目的：代表性的收款人计划帮助严重精神病患者管理他们的社会保障金，以支付必需品的费用，避免无家可归和再次住院。本研究探讨了一个代表性的收款人计划，由社区精神卫生中心，以确定标准的临床医生和个案管理人员将客户转介到该计划，并了解是否参与该计划与减少住院。研究方法：这项回顾性研究包括56名患有严重精神疾病的人，他们在芝加哥社区咨询中心参加了一年的代表性收款人计划，并且在入学前至少一年接受了该机构的服务。通过图表审查确定了将客户介绍给代表性收款人方案的标准。整个样本在入组前和入组后的州住院数据可用; 33名客户的子集可获得关于医疗补助资助的私人住院的额外数据。结果如下：参加代表性收款人计划的最常见标准是共病药物滥用或依赖（49%），无家可归史（33%）和频繁住院（32%）。在参加代表性收款人计划的一年中，与入学前一年相比，在州立医院度过的平均天数明显减少，从68天减少到7天。在国立和私立医院的住院天数也有类似的减少，从97天减少到15天。结论：在缺乏更严格的设计的情况下，这项干预前后回顾性研究的结果是初步的。然而，研究结果表明，代表性收款人计划是相当有效的减少住院时间。
Objective: Representative payee programs help severely mentally ill individuals manage money from their Social Security payments to cover expenses for necessities and to avoid homelessness and rehospitalization. This study examined a representative payee program operated by a community mental health center to determine the criteria used by clinicians and case managers to refer clients to the program and to learn whether participation in the program was associated viith reductions in hospitalization. Methods: The retrospective study included 56 individuals with severe mental illness who were enrolled in the representative payee program at Community Counseling Centers of Chicago for one year and who also had received services from the agency for at least one year before enrollment. Criteria used to refer clients to the representative payee program were determined through chart reviews. Data on state hospitalizations before and after enrollment were available for the entire sample; additional data on Medicaid-funded private hospitalizations were available for a subset of 33 clients. Results: The most common criteria for enrollment in the representative payee program were comorbid substance abuse or dependence (49 percent), a history of homelessness (33 percent), and frequent hospitalizations (32 percent). During the year of participation in the representative payee program, the mean number of days spent in state hospitals decreased markedly compared with die year before enrollment, from 68 days to seven days. A similar reduction was noted in the number of days spent in state and private hospitals, from 97 days to 15 days. Conclusions: Findings from this pre- and postintervention retrospective study are tentative in the absence of a more rigorous design. However, the results suggest that the representative payee program is quite effective in reducing hospital stays.