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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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PubMed1999

["Self-inflicted injuries"--psychiatric, forensic and insurance aspects (II)].

German law distinguishes between attempted suicide which is not punishable and self-mutilation which is prohibited. This article describes the historical development of self-injurious behaviour, reviews the social, juridical, and ethical assessments of the past, and examines the statistical and biological results of current research. It relates observations from forensic medicine and psychiatry to specific clinical symptoms, toxicological circumstances, and social influences (stress incurred by everyday life, war, or imprisonment). Drawing on pertinent cases, it clarifies criminal and civil jurisdiction and emphasizes the importance of self-mutilation for private insurers. Intended for insurers, forensic scientists, and psychiatrists, recommendations concern the procedures to be followed in the examination, jurisdiction, and therapy involving cases of self-inflicted injuries.

Forensic Medicine↗
PubMed1998

Psychiatric hospitalization characteristics associated with insurance type.

This study examines the relationship among types of insurance and characteristics of inpatient psychiatric treatment. Data include 46,998 adult psychiatric or substance abuse cases from all 1991-1992 Washington State discharges from short-stay general hospitals. Large and significant differences among payers exist in treatment characteristics, controlling for diagnosis and patient age. For example, length of stay is longest among commercial and Medicare payers. Emergency admissions are more common among public payers, and elective admissions are more common among private payers, including HMOs. Results and discussed in light of policy and administration issues that will arise as financing for mental health services comes under greater capitation.

Adult↗
PubMed1993

Psychiatric care and health insurance reform.

Concerns about cost, access, and quality of health care in the United States have led to a variety of legislative proposals that would reform our health care system and its financing. Health insurance benefits for mental illness, including substance abuse, are treated differently from medical/surgical benefits, with stricter limits on outpatient visits and hospital days. Medicare, Medicaid, and most private health insurance plans contain this historic disparity of coverage for mental illness compared to general medical illness. Psychiatric services are also distinguishable because of the large public sector reimbursement for mental illness treatment and support. Principles for a more equitable design of mental health benefits include a non-discriminatory approach; payment on the basis of service rather than diagnosis; application of cost containment for care of mental illness on the same basis as care of general medical illness; retention of the public sector as a backup system for high-cost, long-term care; encouragement of lower-cost alternatives to the hospital through the development of a continuum of care; and a recognition of the distinction between psychotherapy and medical management. All current approaches to universal health care fall short of these principles. A research agenda is needed now more than ever in order to articulate the case for complete coverage of mental illness and substance abuse.

Ambulatory Care↗
PubMed1985

Payment for psychiatric services under Canada's insurance system.

The authors review the impact of Canada's universal health insurance system on the delivery of psychiatric services. They believe that, on balance, Canadian psychiatrists and their patients have benefited from the system. However, certain categories of patients still do not have access to private care, and public facilities in some provinces have long waiting lists for services because of manpower shortages. A substantial number of psychiatrists have opted out of the system because of dissatisfaction with the intrusion of third-party payment on practice. The Canadian system presently discourages copayment by patients, and thus has reinforced the public's belief in free medical care as a right. The authors discuss the benefits to some patients of direct payment for services and emphasize the need for direct payment to remain an option under national health insurance.

Canada↗
PubMed1986

Reflections of a CHAMPUS-APA peer reviewer.

Peer review is a major professional response to the problems of health insurance coverage for psychiatric services. Standard insurance programs reimburse only services that are conventional and cost-effective. The system assumes that services are skillfully documented by providers. Experience as a peer reviewer helps clinicians acquire skill in documentation.

Cost-Benefit Analysis↗
PubMed1991

Access to insurance and length of psychiatric stay among adolescents and young adults discharged from general hospitals.

This study examines the characteristics of over 100,000 young people hospitalized in short-term, general hospitals throughout the United States between 1986 and 1988 for psychiatric and substance abuse diagnoses. Adolescent patients (ages 13-17) are compared with young adults (ages 18-22) in terms of demographic characteristics, diagnosis, source of payment, and length of stay. The study focuses on the relationship between the patients' access to private insurance and length of stay.

Adolescent↗