221035 Effectiveness of a High End Users Program for Persons with Psychiatric Disorders

Wednesday, November 10, 2010

Aileen Rothbard, ScD , Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA
Sumedha Chhatre, PhD , Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA
Cynthia Zubritsky, PhD , Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA
Objective: To evaluate the effectiveness of an intensive system of case management, High End User (HEU) program, in reducing psychiatric inpatient utilization at least 50%. Methods: Pre- post analysis compared 2004-07 utilization between intervention and comparison groups. Both groups met the criteria of HEU by virtue of multiple episodes or long stay (30 days or more) in a 12 month period. Propensity sore was used to correct for selection bias. Data from Medicaid claims and consumer reporting forms were used. Logistic regression was used to predict the probability of an inpatient episode in the post period. Results: Majority of HEU, regardless of participation in intervention program, had a reduction of 50% or more in inpatient days. Logistic regression results indicate that being in an HEU intervention program did not result in greater inpatient reduction, after adjusting for covariates. Conclusion: Our results are consistent with previous studies that find that majority of HEU have lower utilization in the following year, regardless of an intervention. Our study indicates that most HEU have one major crisis episode that is not repeated in the following year.

Learning Areas:
Public health or related public policy
Public health or related research

Learning Objectives:
Identify ways to classify high end users of psychiatric inpatient services. Formulate a methodology for assessing the effectiveness of intervention programs to reduce high use of psychiatric services.

Keywords: Mental Health Services, Intervention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health services researcher
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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