Biomedical subjects

S P Falcon

Publications and source records attributed to S P Falcon.

4 recordsLinked to original sources

PubMed1996

Longitudinal patterns of care for patients with posttraumatic stress disorder.

This study assessed patterns of mental health service use over time by patients with posttraumatic stress disorder (PTSD) - as compared with patients with schizophrenia and major depression - with emphasis on the persistence and episodic versus continuous nature of use. Data on utilization were extracted from Veterans Health Administration (VA) administrative data bases. Temporal patterns of use were categorized into intervals of inpatient, outpatient, and no use. PTSD patients used substantial amounts of mental health services, but averaged 2.2 nonuse intervals lasting more than 100 days each, implying that use was episodic. Use of mental health services by patients with PTSD is substantial, persistent, and quite episodic. To the extent that use of services reflects the course of the disorder, the results suggest that remissions are usually followed by relapse, and that absence of symptoms does not mean that the disorder has run its course.

Analysis of Variance↗

PubMed1992

Age-related psychiatric comorbidities and level of functioning in alcoholic veterans seeking outpatient treatment.

The relationship of age and of level of adaptive functioning to comorbidity of mental disorders among alcoholics was studied in a survey of all alcoholics seeking outpatient mental health treatment in the Veterans Affairs mental health care system during a one-month period in 1986 (N = 22,463). More than half of the alcoholic outpatients had one or more comorbid psychiatric diagnoses. Rates for comorbid substance abuse disorders, posttraumatic stress disorder, schizophrenia, and personality disorders peaked in younger alcoholics and then decreased with age. Age-related increases were observed for major depression, anxiety disorders, and organic brain syndrome or dementia. DSM-III axis V ratings of poor to grossly impaired functioning were consistent across age groups. More than half of alcoholics with a comorbid psychiatric disorder were rated as severely impaired, compared with less than a third of those with no comorbid mental disorder.

Activities of Daily Living↗

PubMed1990

A classification system for long-staying psychiatric patients.

Data on a sample of 890 Veteran's Administration long-staying psychiatric patients were studied to develop a classification system that explains actual daily resource use. Disturbed patients with lengths of stay of less than three years and those with psychotic conditions who are not withdrawn represent the two groups found to use significantly more resources in their daily care. The Long-Stay Psychiatric Patient Classification (LPPC) System, with six categories, explains 11.4% of the variability in per diem resource use and can be used for case-mix adjustment of payments for psychiatric care.

Data Interpretation, Statistical↗

PubMed1989

A psychiatric patient classification system. An alternative to diagnosis-related groups.

It is generally accepted that diagnosis-related groups (DRGs) for alcohol, drug, and mental disorders are inappropriate for inpatient prospective payment. To address this issue, the Veterans Administration (VA) supported a project to construct alternative classes that are more clinically meaningful, more homogeneous in their resource use, and that account for more variation in resource use among psychiatric and substance use cases than existing DRGs. This paper reports on this project. Using a data set containing universally available discharge data plus behavioral, social, and functional information obtained by a survey of 116,191 discharges from VA psychiatric beds, and with AUTOGRP as the classifying algorithm, a classification system was formed. Twelve psychiatric diagnostic groupings (PDGs) were identified, analogous to major diagnostic groups in the DRG system. Within each PDG, from 4 to 9 terminal groups of Psychiatric Patient Classes (PPCs) were formed and validated. The 12 substance abuse PPCs explain greater than 31% of the variation in length of stay; for the mental disorder PPCs the variance explanation is greater than 11%, a substantial improvement over DRGs that, for the same data set, explain less than 2 and 3%, respectively. With the addition of only 5 variables beyond those presently included in discharge data sets, greater precision for payment purposes can be achieved. Implications for adoption of this classification system are discussed.

Algorithms↗