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E Kamis-Gould

Publications and source records attributed to E Kamis-Gould.

7 recordsLinked to original sources
PubMed1999

The impact of closing a state psychiatric hospital on the county mental health system and its clients.

OBJECTIVE: This three-year study examined the impact of closing a state psychiatric hospital in 1991 on service utilization patterns and related costs for clients with and without serious mental illness. METHODS: The cohort consisted of all individuals discharged from state hospitals and those diverted from inpatient to community services and enrolled in the unified systems project, a state-county initiative to build up the service capacity of the community system. The size of the cohort grew from 1,533 enrollees to 2,240 over the three years. Information on the types, amounts, and cost of all services received by each enrollee was compiled from multiple administrative databases, beginning two years before enrollment and for up to three years after. The data were analyzed to reveal patterns of and changes in service utilization and related costs. RESULTS: Replacement of most inpatient services with residential and ambulatory services resulted in significant cost reduction. For project enrollees, a 94 percent reduction in state hospital services resulted in cost savings of more than $45 million during the three-year evaluation period. These savings more than offset the funds used to expand community services. Overall, the net savings to the system for mental health services for this group was $3.4 million over three years. CONCLUSIONS: The hospital closure and infusion of funds into community services produced desired growth of those services. The project reduced reliance on state psychiatric hospitalization and demonstrated that persons with serious mental illness can be effectively treated and maintained in the community.

Aged↗
PubMed1992

National data standards for mental health management and performance indicators.

National developments suggest that the Mental Health Statistics Improvement Program (MHSIP) offers a suitable philosophical framework as well as standards for a minimum core of mental health data for the total field. With an emphasis on agency-level development and use of data systems, MHSIP could further management objectives in both the public and private sectors. Performance indicators derived from the MHSIP content could be the vehicle for the transformation of automated reams of data into a meaningful and useful consolidated management tool, a tool that would also further quality of care. This article briefly describes the background and content of the MHSIP and the type of performance indicators that can be derived from it and used by management.

Data Collection↗
PubMed1990

Organizational determinants of efficiency and effectiveness in mental health partial care programs.

The use of partial care as a treatment modality for mentally ill patients, particularly the chronically mentally ill, has greatly increased. However, research into what constitutes a "good" program has been scant. This article reports on an evaluation study of staff productivity, cost efficiency, and service effectiveness of adult partial care programs carried out in New Jersey in fiscal year 1984/1985. Five program performance indexes are developed based on comparisons of multiple measures of resources, service activities, and client outcomes. These are used to test various hypotheses regarding the effect of organizational and fiscal variables on partial care program efficiency and effectiveness. The four issues explored are: auspices, organizational complexity, service mix, and fiscal control by the state. These were found to explain about half of the variance in program performance. In addition, partial care programs demonstrating midlevel performance with regard to productivity and efficiency were observed to be the most effective, implying a possible optimal level of efficiency at which effectiveness is maximized.

Adolescent↗
PubMed1987

The New Jersey performance management system: a state system and uses of simple measures.

The New Jersey Performance Management System (PMS) is a major mechanism used by the leadership of the New Jersey Division of Mental Health and Hospitals to contract for, monitor and manage community mental health services. The goal of PMS is to foster proactive, data-based management via sound assessment of multi-dimensional performances, equitable distribution of resources and introduction of incentives. This paper describes PMS, its components, implementation, and limitations.

Community Mental Health Services↗
PubMed1986

Manpower information and the community mental health system.

The lack of knowledge about basic manpower issues in the community mental health system led the authors to devise five questions that address manpower issues of general interest to community mental health system managers. The questions concern the ratio of staff to population, the types of professionals on staff and their demographic characteristics, the amount of time staff spend on various activities, the cost of the work force, and the outcomes of services. The authors discuss how these questions have been considered in the literature, and they illustrate with analyses of data from a survey of staff of New Jersey's mental health agencies how the issues of number, type, and cost of staff can be explored. The authors believe that basic manpower information can contribute directly to the decisions of managers of mental health service systems.

Community Mental Health Services↗
PubMedDate not supplied

The Swedish mental health system. Past, present, and future.

In sum, the evolution, strengths, and weaknesses of the Swedish mental health system are quite similar to mental health systems in other Western countries; early reliance on stand-alone, state psychiatric hospitals, followed by deinstitutionalization and development of largely ambulatory, community mental health care. This evolution has been complicated in Sweden by the multiple levels and system components, the state, the county councils and the municipalities. Unlike the United States, but similar to Britain, community mental health care in Sweden is provided by two systems; treatment (and forensic services) by the county councils' mental health providers, and generic services by the municipalities' social welfare system. The resulting division of roles and responsibilities creates a strong need for collaboration and coordination of activities on behalf of consumers. It can also have the unintended disincentives to serving more difficult consumers. All these difficulties not withstanding, the Swedish mental health system has made major stride in providing quality, appropriate care.

Deinstitutionalization↗