3060.0: Monday, October 22, 2001 - Table 2

Abstract #24850

Privatization of outpatient mental health services: An assessment of one county’s experience

Traci Tunkelrott, MPP1, John P. Papay1, Karen W. Linkins, PhD1, and Gail K. Robinson, PhD2. (1) The Lewin Group, 3130 Fairview Park Drive, Suite 800, Falls Church, VA 22042, 703-269-5675, traci.tunkelrott@lewin.com, (2) Abt Associates, 1110 Vermont Avenue, N.W., Suite 610, Washington, DC 20005

Objective. This paper assesses the impact of privatizing county-operated adult outpatient mental health services on consumer access to and quality of care. The study examines trends in inpatient and outpatient utilization, including admissions, length of stay, readmission rates, and follow-up treatment.

Study Design. A pre-post study design was used to assess the impact of privatization over a three-year time period. A ten percent sample was drawn from the 643 clients receiving treatment in one of four outpatient mental health clinics. Data were analyzed using univariate and bivariate statistics. To account for differences in clinical severity, analyses controlled for diagnosis. Data were extracted from patient charts for a select number of indicators including patient demographics, diagnosis, functioning level, and utilization of inpatient and outpatient services.

Principal Findings. Findings include: 1) Clients in the sample were hospitalized more often and for longer durations after the transition to privatized care. Inpatient admission increased by 55 percent, while the average length of stay increased by nearly 60 percent (from 5.22 to 8.35 days); 2) Once discharged, clients received less timely follow-up care at outpatient clinics. The length of time between discharge from inpatient facilities and follow-up treatment at outpatient clinics increased by over 74 percent (from 9 to 16 days); and 3) Visits for medication management increased (from 7.6 to 8.3 visits per year), while the average number of individual and group therapy visits decreased.

Learning Objectives: 1. Examine a county-based model for privatizing outpatient mental health services 2. Describe how privatization of outpatient mental health services influences the utilization and quality of inpatient and outpatient care

Keywords: Privatization, Mental Health Services

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA