Costs of community-based public mental health services for older adults: variations related to age and diagnosis.
Int J Geriatr Psychiatry
; 21(12): 1121-6, 2006 Dec.
Article
em En
| MEDLINE
| ID: mdl-16977681
ABSTRACT
BACKGROUND:
Several studies have examined service use among older adults although, to our knowledge, none has examined costs from a systems perspective. This study examined use and costs of mental health services among older adults in San Diego County in order to determine how expenditures and modes of service varied by age cohort and psychiatric diagnosis.METHODS:
Utilization data from San Diego County Adult and Older Adult Mental Health Services (AOAMHS) were used to identify older adults (age > or = 60) receiving services in the community during fiscal year 2003-2004. Cost data were derived from detailed examination of cost reports, and Medicaid fee schedules. Trends in demographic and clinical characteristics by six age cohorts were described. Multivariate models were used to estimate the relationships between costs, age, and clinical diagnosis while controlling for other demographic and clinical characteristics. Components of costs were also examined.RESULTS:
Total expenditures declined from age cohorts 60-64 through ages 85 and over. Expenditures were similar, and greatest, for clients with schizophrenia and bipolar disorder, while outlays were lower for those with major depression, other psychotic disorder, other depression, anxiety, substance use disorder, and cognitive disorders. Clients diagnosed with cognitive disorder had high use of emergency services and little connection to outpatient services.CONCLUSIONS:
Expenditures were related to age and clinical diagnosis. Future efforts should investigate older adults' pathways to care, and should determine whether older adults presenting in emergency services would benefit from a specialized case management program providing linkages to community based resources.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Custos de Cuidados de Saúde
/
Serviços Comunitários de Saúde Mental
/
Serviços de Saúde para Idosos
/
Transtornos Mentais
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
Limite:
Aged
/
Aged80
/
Humans
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Int J Geriatr Psychiatry
Assunto da revista:
GERIATRIA
/
PSIQUIATRIA
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Estados Unidos