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Biomedical subjects

E N Goplerud

Publications and source records attributed to E N Goplerud.

8 recordsLinked to original sources
PubMed1986

Assessing methods of predicting the need for psychiatric beds.

Actual psychiatric bed utilization in 16 metropolitan areas was compared with projected bed needs in those areas derived from seven common methods of assessing the need for inpatient psychiatric services. Six methods significantly underpredicted actual use, and one significantly overpredicted actual use. Methods that relied on multiple sources, including expert opinion, historical use, epidemiologic data, and social indicators, predicted need more accurately than those that relied exclusively on expert opinion or historical use. The author also found that utilization rates of acute beds in general and specialty hospitals kept pace with licensed bed rates at or below 45 to 50 beds per 100,000 population but remained steady if the number of licensed beds went higher. The author recommends reliance on local indicators to plan inpatient services.

Bed Occupancy↗
PubMed1986

Effects of proprietary management in general hospital psychiatric units.

The rapid increase in the number of proprietary psychiatric hospitals during the last 15 years has drawn criticism from those concerned about the impact of the profit motive on the quality of patient care. This study assessed changes in the structure and quality of care on 13 acute care psychiatric units before and after a single outside proprietary firm was hired to manage the units. The study found significant improvements in many areas after the change; they included higher occupancy rates, higher staffing levels, more hours of staff inservice training, higher collections-to-billings ratios, and improved program structure and process as measured by Joint Commission on Accreditation of Hospitals criteria. No changes were found in the length of stay or diagnostic mix of patients. The findings indicate that program quality and profit are not necessarily incompatible, but the author cautions against making generalizations to other situations based on the small study sample.

Bed Occupancy↗
PubMed1985

Planning acute psychiatric services: a survey of current practice.

Several factors have combined to make planning for acute psychiatric inpatient services an important concern of health planners. We report on a nationwide survey of the planning methods used by state health planning agencies to certify need for acute psychiatric services. The results indicate that very few state agencies have developed sophisticated planning methods. The majority use simple bed-to-population ratios, which vary widely from state to state, or rely on past utilization to predict future demands. One-fourth of the states have no method for determining need. The implications of these findings for informed, meaningful planning of psychiatric services are discussed.

Community Mental Health Services↗
PubMed1985

Weathering the cuts: a Delphi survey on surviving cutbacks in community mental health.

Funding reductions and changes in the priorities of funding agencies have deeply affected community mental health programs. The burden of handling resource scarcity and shifting service priorities falls primarily on the community boards and staff of local agencies. We report a Delphi study in which an expert panel of 106 community mental health center executive directors and government officials generated a list of key strategies that local agencies could take to survive cutbacks. From an initial list suggested by the panel, a consensus was developed on the 15 most important and most feasible strategies. Discussion focuses on the implications and use of these strategies to promote the survival, even growth, of community-based mental health services during times of scarcity.

Community Mental Health Services↗
PubMed1984

Pitfalls in planning: contrasting perspectives on mental health and corporate planning.

Planning is a management activity that has been linked to high quality services, organizational growth, and in austere times, to organizational survival. The present study was undertaken to identify the critical barriers that inhibit or derail effective planning. It was predicted that human service and corporate managers would generally agree about the most and least important planning pitfalls in their systems. Discrepancies would be related to differences in the structural characteristics of organizations in the two sectors. Rankings made by 57 senior mental health administrators of the most and least important pitfalls in planning were contrasted with those of 159 corporate executives. Substantial agreement between the two groups of executives was found.

Analysis of Variance↗
PubMed1983

Surviving cutbacks in community mental health: seventy-seven action strategies.

The question of how community mental health centers could best weather cutbacks in funding was addressed in this study. A survey was conducted with a panel of experts in this area yielding a total of 77 action strategies that agencies could utilize in these difficult financial times. These strategies are reported in terms of services, treatment modalities, consultation, education and training, staffing, personnel policies, location of services, finance and business practices, third party reimbursement, overhead and administrative costs, role of the Board, monitoring the external environment and linkages and contacts. It was recommended that these strategies not be utilized as a recipe for survival but rather as a self-study guide by individual agencies.

Community Mental Health Centers↗
PubMed1979

Unexpected consequences of deinstitutionalization of the mentally disabled elderly.

An unexpected consequence of the rapid deinstitutionalization of state mental hospital patients has been a sharp rise in posttransfer mortality among the elderly. Considerable evidence suggests that outcome is mediated by two factors. Elderly patients with certain characteristics - especially physical frailty and severe cognitive impairement - comprise a high-risk subgroup for whom relocation is likely to be fatal. Among other elderly persons, environmental, personality and personality-environment congruence are associated with posttransfer prognosis. The studies reviewed indicate that the therapeutic value of deinstitutionalization for mentally disabled elderly persons is problematic.

Aged↗