Medicaid cutbacks and state psychiatric hospitalization of patients with schizophrenia.
Medicaid cutbacks and state psychiatric hospitalization of patients with schizophrenia.
复制标题
医疗补助削减和精神分裂症患者的国家精神病院住院治疗。
DOI：
10.1176/ps.62.8.pss6208_0871
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Collins,JonC
中科院分区：
文献类型：
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作者：
McFarland,BentsonH;Collins,JonC
考虑到国民经济衰退引发的财政困难，国家政策制定者对医疗补助削减对精神分裂症患者的影响很感兴趣。从2003年开始，俄勒冈州立法机构取消了对大量人群的所有医疗补助，其中包括许多精神分裂症患者。这个项目的目的是研究国家精神病医院利用率与精神分裂症的人谁保持或失去Medicaid coverage.MethodsThis纵向队列研究探讨了俄勒冈州精神分裂症患者谁使用医疗补助的心理健康服务之前，国家的大规模医疗补助削减。数据来自国家心理健康，医疗补助和生命统计机构。结果的措施是非自愿的精神病住院综合医院和国家精神病医院，分别。有三个队列，其中包括那些谁失去了医疗补助覆盖在2003年（N=435），那些谁失去了医疗补助覆盖在2004年（N=187），和那些谁保持医疗补助覆盖整个研究年2002-2004年（N=3,427）。控制年龄、性别、种族、医疗补助资格和医疗保险覆盖范围的分析显示，维持医疗补助覆盖范围的人在州精神病住院治疗方面几乎没有变化，而随着时间的推移，失去医疗补助覆盖范围的人的利用率显着增加（p<.003）。在综合医院精神科的利用率方面几乎没有差异。医疗补助覆盖范围的损失，一般在住院前。ConclusionsState政策，旨在减少医疗补助注册可能会导致增加使用国家精神病医院的前医疗补助登记与精神分裂症。（精神病学服务62：871-877，2011）
ObjectiveGiven financial difficulties precipitated by the flagging national economy, state policy makers are interested in the impact of Medicaid cutbacks on individuals with schizophrenia. Starting in 2003, the Oregon legislature eliminated all Medicaid coverage for large numbers of people, including many with schizophrenia. The objective of this project was to examine state psychiatric hospital utilization among persons with schizophrenia who maintained or lost Medicaid coverage.MethodsThis longitudinal cohort study examined Oregon schizophrenia patients who had used Medicaid mental health services before the state's massive Medicaid reductions. Data were obtained from the state mental health, Medicaid, and vital statistics agencies. The outcome measures were involuntary psychiatric admissions to general hospitals and to state psychiatric hospitals, respectively. There were three cohorts, which comprised those who lost Medicaid coverage in calendar year 2003 (N=435), those who lost Medicaid coverage in 2004 (N=187), and those who maintained Medicaid coverage throughout study years 2002–2004 (N=3,427).ResultsCohort members were on average 43 years old, and the sample was 42% female and 88% white. Analyses controlling for age, gender, race-ethnicity, Medicaid eligibility, and Medicare coverage showed that persons who maintained Medicaid coverage had little change in state psychiatric hospitalization, whereas utilization increased markedly over time for those who lost Medicaid coverage (p<.003). There were few differences in utilization of general hospital psychiatric units. Loss of Medicaid coverage generally preceded hospitalization.ConclusionsState policies designed to decrease Medicaid enrollment may have led to increased use of state psychiatric hospitals by former Medicaid enrollees with schizophrenia. (Psychiatric Services62:871–877, 2011)