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M J Namerow

Publications and source records attributed to M J Namerow.

5 recordsLinked to original sources
PubMed1991

Why study treatment outcome?

Concern about the spiraling cost of mental health care has increased the need for reliable data about the outcomes of such care. Treatment outcome studies, although difficult to design and carry out, are essential in demonstrating the efficacy of psychiatric treatment, rationalizing clinical decision making, and encouraging public support for the availability of appropriate, cost-effective care for the mentally ill. Ideally, outcome studies should focus not only on clinical symptomatology but also on patients' social, interpersonal, and occupational adjustment as well as on factors that, taken together, shape the quality of life. The authors discuss these issues and some of the impediments to collecting useful outcome data, including the complexity of the mental health service delivery system and problems related to patient selection, study design, and how treatment is defined.

Cost-Benefit Analysis↗
PubMed1991

The NAPPH (National Association of Private Psychiatric Hospitals) critical indicator project.

The National Association of Private Psychiatric Hospitals (NAPPH) initiated the Critical Indicator Project in 1986 to develop measures of quality and other important clinical aspects of inpatient psychiatric treatment. The tools used to collect data have undergone extensive refinements, and the data collected have been analyzed by researchers and clinicians. After careful review, in January 1990 the NAPPH Board of Trustees endorsed full implementation of the Critical Indicator Project in all member hospitals. This paper describes the project and its current major implications.

Data Collection↗
PubMed1986

Prospective payment for psychiatry--feasibility and impact.

Although 15 diagnosis-related groups (DRGs) have been proposed for psychiatric hospital patients, psychiatric hospitals are currently exempt from the DRG prospective payment system. We investigated the ability of the psychiatric DRGs to predict the hospital length of stay and costs by retrospectively analyzing the charts of 8816 randomly selected patients from 32 psychiatric hospitals throughout the United States. In addition, we developed other grouping systems to see whether they would have been better predictors of length of stay. We found that grouping the patients in the 15 psychiatric DRGs reduced the total variance in length of stay by only 3.9 percent. Furthermore, our best alternative grouping--based on major diagnostic categories, whether the patient was transferred from another facility, age, and psychiatric complications and comorbidities--reduced the variance by only 7.8 percent. We conclude that DRGs do not adequately predict length of stay or costs in psychiatric hospitals. We identified factors other than diagnosis that predicted the length of stay better, but all the models we tested would create large financial "winners" and "losers" and thus introduce inappropriate incentives into the care of patients in psychiatric hospitals.

Costs and Cost Analysis↗