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Related Experiment Videos

Controlling inpatient psychiatric utilization through managed care

T M Wickizer1, D Lessler, K M Travis

  • 1Department of Health Services, University of Washington, Seattle, 98195-7660, USA.

The American Journal of Psychiatry
|March 1, 1996
PubMed
Summary

Managed care utilization management significantly restricts inpatient psychiatric care, mainly by limiting the length of stay. This approach appears to follow strict protocols, impacting treatment duration for mentally ill patients.

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Area of Science:

  • Health Services Research
  • Psychiatric Care Management
  • Mental Health Policy

Background:

  • Limited understanding exists on how managed care impacts inpatient psychiatric services for individuals with mental illness.
  • Utilization management is a key managed care strategy involving review and authorization of psychiatric care requests.

Purpose of the Study:

  • To examine the effects of utilization management on hospital inpatient psychiatric care.
  • To analyze how preadmission review, continued-stay review, and case management influence treatment authorization.

Main Methods:

  • Analysis of 2,265 utilization management reviews from 1989-1992 for a commercial insurance company.
  • Evaluation of admission request approval rates, requested versus approved treatment days, and treatment extension approvals.

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Main Results:

  • Nearly all (98.8%) initial inpatient psychiatric treatment requests were approved.
  • Authorized days of care averaged only one-third of those requested (6.9 vs. 19.0 days).
  • Patients with alcohol or drug dependence diagnoses experienced more restricted care compared to others.

Conclusions:

  • Managed care, specifically utilization management, restricts inpatient psychiatric care, primarily by controlling the length of stay.
  • The uniform initial approval length suggests adherence to rigid treatment protocols, potentially overlooking individual patient needs.
  • Further research is crucial to assess the impact of managed care on the quality and outcomes of psychiatric treatment.