Trends in Treatment: Psychiatric Hospitals Evolve into Systems of Care

Article excerpt

The addictions field might do well to study a new report released by the National Association of P Health Systems (NAPHS), which deals with the reality of managed care.

The 1992 Annual Survey: Final Report indicates that more patients are entering specialty psychiatr under some form of external review, remaining for shorter lengths of stay, and finding more availabl options, including partial hospitalization and residential treatment.

Even with the widespread use of managed care between 1990 and 1992, there has been remarkable stab the types of patients seen in specialty hospitals, including alcohol and other drug treatment center that about the same proportion of young people were admitted to private psychiatric hospitals during period, even though the average length of stay declined. In 1992 adolescents represented 19.9 percen compared with 20.9 percent in 1990. Adults remained at 55.3 percent of discharges; older adults were discharges, compared with 4.6 percent in 1990; and discharges from alcohol- and drug-related program percent, compared with 15.1 percent in 1990.

The majority of patients, 65.5 percent, enter private psychiatric hospitals only after some type o preadmission approval, and 70.5 percent required outside review to extend their stay. More than 98 p admissions and 95.7 percent of requests for extended stay were approved by an outside reviewer. Hosp 88.3 percent of admission denials and won 51.9 percent of the appeals. More than 80 percent of denia for continued stay were appealed, and hospitals won 56.6 percent of those appeals.

Not surprising, length of stay was down in virtually all hospital-based programs. …