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Medicaid cutbacks and clients with severe mental illness

医疗补助削减和患有严重精神疾病的客户

基本信息

批准号：
7197349
负责人：
BENTSON H MCFARLAND
金额：
$ 7.47万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-03-09 至 2008-08-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7197349
关键词：
Accounting Address Advocate Ambulatory Care Bipolar Disorder Budgets Case Study Charge Client Computer Systems Condition Data Data Analyses Databases Drug Prescriptions Economics Enrollment Event Face Family Freedom Funding Future Grant Growth Health Health Care Costs Health Services Research Hospitalization Housing Human Individual Information Systems Link Mechanics Medicaid Medicare/Medicaid Medicine Mental Health Mental Health Services Mental disorders Methodology Numbers Observational Study Occupations Oregon Outcome Outcome Measure Outpatients Personal Satisfaction Persons Pharmaceutical Preparations Police Policies Policy Maker Prisons Published Comment Purpose Rate Resolution Review Committee Risk Schizophrenia Services Speech Structure Substance abuse problem System Taxes Technology Tennessee Time Unemployment Utah Virginia Vital Statistics Work authority cost dual eligible harman interest mortality payment pharmacy benefit prescription document prescription procedure pressure programs response severe mental illness

项目摘要

DESCRIPTION (provided by applicant): This proposal is a revision of application number R03 MH074471-01 which was reviewed February 9, 2005 by the Mental Health Services Research Review Committee. The application has been substantially revised to address reviewer comments. Data base descriptions have been expanded, outcome measures are better described, the analysis plan and power calculations have been simplified and clarified, and the budget has been re-allocated. In the meantime, policy-makers remain greatly interested in the impact of Medicaid reductions on individuals with severe mental illness. Indeed, people with severe mental illnesses such as schizophrenia or bipolar disorder depend heavily on Medicaid to pay for services including outpatient care and medications. Unfortunately, states have recently reduced Medicaid enrollment and-or benefits. The proposed federal budget also anticipates notable shrinkage in Medicaid. The impact of this service reduction remains to be seen. Yet this information will be of considerable interest to policy-makers. Oregon provides what may well be the nation's most dramatic example of Medicaid enrollment and benefit reductions. Beginning in 2000, Oregon faced substantial unemployment associated with declines in manufacturing, exports, and high technology. In response, the Oregon legislature eliminated all Medicaid coverage for large numbers of people while curtailing mental health, substance abuse, and-or pharmacy benefits for other groups of Medicaid clients. The purpose of the proposed secondary data analysis project is to examine the impact of these cutbacks on people with severe and persistent mental illnesses such as schizophrenia or bipolar disorder. This observational study will examine Oregon Medicaid clients who had used mental health services prior to the state's massive Medicaid reductions in 2003 and 2004. Data will be obtained from several linked information systems operated by the state mental health agency, the state Medicaid agency, the state police, the prison system, sheriffs, and the state vital statistics agency. Outcome measures will include psychiatric hospitalizations, arrests, and mortality. Rates of these events will be compared between time periods when clients were and were not receiving outpatient services and-or medication. Analyses will take into account varying "times at risk" for subjects who may be hospitalized or arrested. The results will be of keen interest to decision-makers who determine Medicaid policies.

描述（由申请人提供）：本提案是申请编号R 03 MH 074471 -01的修订版，该申请于2005年2月9日由精神卫生服务研究审查委员会审查。已对应用程序进行了实质性修改，以解决审查员的意见。数据库的描述已经扩大，成果计量得到更好的描述，分析计划和功效计算得到简化和澄清，预算已经重新分配。与此同时，政策制定者仍然对医疗补助减少对严重精神疾病患者的影响非常感兴趣。事实上，患有精神分裂症或双相情感障碍等严重精神疾病的人严重依赖医疗补助来支付包括门诊护理和药物在内的服务。不幸的是，各州最近减少了医疗补助计划的注册和/或福利。拟议中的联邦预算还预计医疗补助计划将显著缩水。这种服务减少的影响还有待观察。然而，这些信息将对决策者产生相当大的兴趣。俄勒冈州提供了什么很可能是全国最戏剧性的例子，医疗补助登记和福利削减。从2000年开始，俄勒冈州面临着与制造业、出口和高科技下降相关的大量失业。作为回应，俄勒冈州立法机构取消了大量人的所有医疗补助覆盖范围，同时减少了其他医疗补助客户群体的心理健康、药物滥用和/或药房福利。拟议的二级数据分析项目的目的是检查这些削减对患有严重和持续性精神疾病（如精神分裂症或双相情感障碍）的人的影响。这项观察性研究将调查俄勒冈州医疗补助的客户谁使用心理健康服务之前，该州的大规模医疗补助削减在2003年和2004年。数据将从州精神卫生局、州医疗补助局、州警察局、监狱系统、治安官和州生命统计局运营的几个链接信息系统中获得。结果指标将包括精神病住院、逮捕和死亡率。这些事件的发生率将在客户接受和不接受门诊服务和/或药物治疗的时间段之间进行比较。分析将考虑可能住院或被捕的受试者的不同“风险时间”。这些结果将引起决定医疗补助政策的决策者的浓厚兴趣。