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Biomedical subjects

A H Spiro

Publications and source records attributed to A H Spiro.

6 recordsLinked to original sources
PubMed1994

Psychiatric home care: a new tool for crisis intervention.

The cost of psychiatric care has been rapidly increasing in recent years. Between 1984 and 1987, there was a 46 percent increase in psychiatric hospitals beds and a 60 percent increase in psychiatric units in general hospitals. This reflected a recognition by many health care systems that psychiatric patients were a good source of revenue. With this push toward more and more inpatient programs, crucial aspects of psychiatric care were left behind. Specifically, the limitations of inpatient therapy have not been recognized. Within the past five years, a new program has been developed and pioneered to use home care to prevent psychiatric hospitalizations and to also prevent the difficult transitions for psychiatric patients. Over a two-year period, this program was studied for its impact on the quality and cost of psychiatric care.

Contract Services↗
PubMed1991

A multifaceted approach to managed mental health care.

While many HMOs and insurance companies have contracted with outside managed mental health firms to control mental health utilization, ConnectiCare, an IPA Model HMO with nearly 100,000 members, manages its own mental health utilization with a multifaceted approach. How the system has evolved and preliminary results are presented to illustrate how an HMO can manage its own mental health care program while using local providers.

Concurrent Review↗
PubMedDate not supplied

Evaluation and medical therapy of acute gastrointestinal bleeding.

Gastrointestinal bleeding is a major reason for hospitalization and an important cause of morbidity and mortality. Diagnosis and treatment of this common clinical problem has changed markedly over the past 40 years. The initial approach to patients with gastrointestinal bleeding should be both therapeutic and diagnostic, with close attention to cardiovascular status and clotting parameters. Once the patient is stabilized, clinical history, physical examination, gastric aspirate, and laboratory data should be assessed to determine if the bleeding site is in the upper or lower gastrointestinal tract. Once that is determined, a more specific diagnosis should be made if possible, as therapy often will depend upon a precise diagnosis. Therapy includes angiographic and pharmacologic techniques, as well as tamponade in the case of esophageal varices. The use of antacids in acute upper gastrointestinal bleeding is well established, while the role of cimetidine is less clear. Newer modalities of treatment, such as the use of laser coagulation, are currently being evaluated.

Angiography↗