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Adult health care services and psych...

Bledsoe, Sarah Elizabeth.

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Adult health care services and psychiatric disorders: The use and costs of health care services in a low income, minority population coming to an urban primary care clinic.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Adult health care services and psychiatric disorders: The use and costs of health care services in a low income, minority population coming to an urban primary care clinic./
Author:	Bledsoe, Sarah Elizabeth.
Description:	211 p.
Notes:	Adviser: Edward J. Mullen.
Contained By:	Dissertation Abstracts International68-06A.
Subject:	Health Sciences, Mental Health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3266535
ISBN:	9780549054849

Adult health care services and psychiatric disorders: The use and costs of health care services in a low income, minority population coming to an urban primary care clinic.
Bledsoe, Sarah Elizabeth.

Adult health care services and psychiatric disorders: The use and costs of health care services in a low income, minority population coming to an urban primary care clinic. - 211 p.

Adviser: Edward J. Mullen.

Thesis (Ph.D.)--Columbia University, 2007.

Background. Psychiatric disorders are associated with increased rates of medical problems and reduced life expectancies. Undiagnosed psychiatric disorders are associated with "overuse" or "misuse" of general medical health care services placing a burden on the general medical health care services delivery system. This problem is particularly relevant in low income, minority patients because the burden of psychiatric disorders is disproportionate. This group of patients has higher prevalence of psychiatric disorders. Furthermore, low-income, minority patients are less likely to seek mental health services, less likely to receive quality, specialty mental health services, and rely heavily on general medical health care services providers for mental health treatment. This study aims to determine the role of psychiatric disorders in the cost and utilization of general medical health care services (excluding mental health care services) for a low-income, minority patient population coming to a primary health care clinic. This research is guided by prior research in two distinct areas: the cost-offset effect and the behavioral health care model.

ISBN: 9780549054849Subjects--Topical Terms:

1017693
Health Sciences, Mental Health.

Adult health care services and psychiatric disorders: The use and costs of health care services in a low income, minority population coming to an urban primary care clinic.
LDR:05662nam 2200337 a 45 001 941546
005 20110519
008 110519s2007 eng d
020 $a 9780549054849
035 $a (UMI)AAI3266535
035 $a AAI3266535
040 $a UMI $c UMI
100 1 $a Bledsoe, Sarah Elizabeth. $3 1265639
245 1 0 $a Adult health care services and psychiatric disorders: The use and costs of health care services in a low income, minority population coming to an urban primary care clinic.
300 $a 211 p.
500 $a Adviser: Edward J. Mullen.
500 $a Source: Dissertation Abstracts International, Volume: 68-06, Section: A, page: .
502 $a Thesis (Ph.D.)--Columbia University, 2007.
520 $a Background. Psychiatric disorders are associated with increased rates of medical problems and reduced life expectancies. Undiagnosed psychiatric disorders are associated with "overuse" or "misuse" of general medical health care services placing a burden on the general medical health care services delivery system. This problem is particularly relevant in low income, minority patients because the burden of psychiatric disorders is disproportionate. This group of patients has higher prevalence of psychiatric disorders. Furthermore, low-income, minority patients are less likely to seek mental health services, less likely to receive quality, specialty mental health services, and rely heavily on general medical health care services providers for mental health treatment. This study aims to determine the role of psychiatric disorders in the cost and utilization of general medical health care services (excluding mental health care services) for a low-income, minority patient population coming to a primary health care clinic. This research is guided by prior research in two distinct areas: the cost-offset effect and the behavioral health care model.
520 $a Method. Secondary data analysis of a cross-sectional survey was used to test the relationship between psychiatric disorders and the types, rates, level of utilization, and cost of general medical health care services in a sample consisting of 1,063 primary care patients at an urban primary care clinic that serves a predominantly immigrant and low-income community. Separate multiple linear regression analyses were conducted both with and without the dichotomous variable indicating presence of a current psychiatric disorder to examine whether there was a significant positive relationship between the presence of a current psychiatric disorder and the level of general medical health care services utilization and the cost of general medical health care services. Separate analyses were run to determine the effects of hypothesized moderating variables: enabling resources and past use of mental health services. Multiple logistic regression analysis was used to examine the hypothesized differences between low and high utilizers of general medical health care services.
520 $a Results. In a sample of primarily low-income, minority, and immigrant primary care patients participants with current psychiatric disorders had greater levels of utilization (M = 11.85, SD = 8.15) and cost (M= $4 ,901.94, SD = 11, 226.29) related to general medical health care services when compared to the sample of participants without current psychiatric disorders (utilization M = 10.86, SD = 8.15; cost M = $3 ,606.03, SD = 5,673.47) after controlling for predisposing characteristics, need, and enabling factors. Having comorbid psychiatric disorders was not significantly associated with either the level of utilization or the cost of general medical health care services. Furthermore, the category of psychiatric disorder (mood, anxiety, or substance related) was not associated with utilization or cost of general medical health care services. The hypothesized moderating relationship of enabling resources and past use of mental health services on the association between having a current psychiatric disorder and both cost and utilization of general medical health care services was not supported.
520 $a Significant differences were detected in the psychiatric sample between the subset of participants who utilized low levels of general medical health care services and the subset of those who utilized high levels of general medical health care services. The low level utilizers were more likely to be Spanish speaking, have alcohol use disorder, and be exposed to more categories of traumatic events. Participants with psychiatric disorders who had Medicaid and those who were disabled were more likely to be high level utilizers of general medical health care service. As percentage of life lived in the United States increased and as health comorbidity increased participants with psychiatric disorders were more likely to be high level utilizers.
520 $a Conclusions. Findings suggest that having a current psychiatric disorder is associated with higher cost and level of utilization of general medical health care services after controlling for other factors. This may be an indication that individuals with psychiatric disorders are not receiving appropriate psychiatric services. Results of this and previous studies support the need for and may fiscally justify increased screening and treatment of psychiatric disorders in general medical health care settings.
590 $a School code: 0054.
650 4 $a Health Sciences, Mental Health. $3 1017693
650 4 $a Health Sciences, Public Health. $3 1017659
650 4 $a Social Work. $3 617587
690 $a 0347
690 $a 0452
690 $a 0573
710 2 0 $a Columbia University. $3 571054
773 0 $t Dissertation Abstracts International $g 68-06A.
790 $a 0054
790 1 0 $a Mullen, Edward J., $e advisor
791 $a Ph.D.
792 $a 2007
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3266535