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[Changed treatment of schizophrenic syndromes. More open care is not cheaper].

https://arctichealth.org/en/permalink/ahliterature215107
Source
Lakartidningen. 1995 May 24;92(21):2203-6, 2209
Publication Type
Article
Date
May-24-1995

A cross-sectional study of private psychiatric practices under a single-payer health care system.

https://arctichealth.org/en/permalink/ahliterature208590
Source
Can J Psychiatry. 1997 May;42(4):395-401
Publication Type
Article
Date
May-1997
Author
K. Anderson
A. Catterson
M. Gaudet
M. Gautam
P J Kerr
M. Pecher
D. Waiser
J. Kaji
M. Fava
Author Affiliation
University of Ottawa, Ontario.
Source
Can J Psychiatry. 1997 May;42(4):395-401
Date
May-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Combined Modality Therapy
Cross-Sectional Studies
Female
Health Services Accessibility - economics - statistics & numerical data
Health Services Misuse - economics - statistics & numerical data
Humans
Infant
Male
Medical Indigency - economics - statistics & numerical data
Mental Disorders - economics - epidemiology - therapy
Middle Aged
Ontario - epidemiology
Private Practice - economics - statistics & numerical data
Psychiatry - economics - statistics & numerical data
Psychotherapy - economics - statistics & numerical data
Psychotropic Drugs - therapeutic use
Referral and Consultation - economics - statistics & numerical data
Single-Payer System - economics - statistics & numerical data
Abstract
To examine current concerns that in the Canadian single-payer mental health care system, the "rich worried well" (that is, wealthy individuals who are worried yet mentally well) may overuse psychiatric services, while low-income, uninsured mentally ill individuals may remain undertreated. The current study focuses on the mental health care in the Canadian region of Ottawa-Carleton, where a single-payer system provides universal access to mental health services, to assess how psychiatric services are provided by psychiatrists in private practice.
One hundred and seven private psychiatrists working in the region of Ottawa-Carleton completed a questionnaire which contained questions about the sociodemographic characteristics and background of the psychiatrists themselves and which asked the psychiatrists specific questions about the sociodemographic status, diagnosis, and treatment of each patient seen on November 10, 1994.
Approximately 93% of the patients seen met criteria for one or more Axis I disorders, of which mood and anxiety disorders were the most common. Wealthier patients were relatively underrepresented among the patients treated by the private psychiatrists. In addition, we found no significant differences in the distribution of Axis I, Axis II, and Axis III disorders between patients earning below $30,000 per year compared with patients earning above $60,000 per year.
Our results suggest that outpatient psychiatric care delivered by private psychiatrists in a Canadian single-payer system targets primarily individuals with major psychiatric disorders and does not seem to favour "the worried well." Larger epidemiological studies with independent assessments of psychiatric populations are necessary to confirm our findings.
Notes
Comment In: Can J Psychiatry. 1998 Jun;43(5):524-59653541
PubMed ID
9161764 View in PubMed
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Current trends in psychiatry care in Finland with special focus on private practice psychiatry and psychotherapy.

https://arctichealth.org/en/permalink/ahliterature152949
Source
Nord J Psychiatry. 2009;63(1):87-90; discussion 90-1
Publication Type
Article
Date
2009
Author
Jyrki Korkeila
Author Affiliation
University of Turku, Harjavalta Hospital, Satakunta Hospital District, Finland.
Source
Nord J Psychiatry. 2009;63(1):87-90; discussion 90-1
Date
2009
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Cost Control - trends
Data Collection
Evidence-Based Medicine
Finland
Forecasting
Health Care Reform - economics - legislation & jurisprudence
Humans
National Health Programs - trends
Physician's Practice Patterns - economics - legislation & jurisprudence - trends
Politics
Private Practice - economics - trends
Professional Autonomy
Psychiatry - economics - trends
Psychotherapy - economics - trends
Abstract
Several previous reforms decentralized Finnish psychiatric services to a great extent. The Ministry of Social Affairs and Health is outlining a proposal for Health Care Law, which makes an effort to centralize and reorganize healthcare. It is not yet possible to see what this will mean for the psychiatric services. In general, the health status of the Finnish population has improved. Although rates of suicides have declined considerably, rates of alcohol-related deaths have risen. Moreover, disability related to major depression has increased drastically, which has lead to a nationwide project called MASTO, which has the aim to improve early detection and treatment of depression. The Ministry of Social Affairs and Health set up a work group, MIND 2009, to draft local working models for mental health and addiction services. To study the significance of psychotherapy in a private practice psychiatric context, the Finnish Psychiatric Association conducted a survey amongst its members. Most psychiatrists in private practice conduct psychotherapy.
PubMed ID
19172501 View in PubMed
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Does psychiatric care by family practitioners reduce the cost of general medical care?

https://arctichealth.org/en/permalink/ahliterature103493
Source
Gen Hosp Psychiatry. 1990 Jan;12(1):19-22
Publication Type
Article
Date
Jan-1990
Author
A. Richman
Author Affiliation
Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
Source
Gen Hosp Psychiatry. 1990 Jan;12(1):19-22
Date
Jan-1990
Language
English
Publication Type
Article
Keywords
Electroconvulsive Therapy - economics
Humans
Mental Health Services - economics
New Brunswick
Physicians, Family - economics
Psychiatry - economics
Psychotherapy - economics
Abstract
This is the first "impact" type of economic study of psychiatric/counseling services from general practitioners. The paper analyzes a province-wide database that collates statistical data from all inpatient and outpatient psychiatric services as well as from private physicians. This paper asks whether psychiatric services from family physicians also reduce the overall costs of medical care. This research supports the general research findings that medical costs are lower after psychiatrists' care. ECT patients show a marked reduction in their medical costs. Patients with psychotherapy/counseling from family physicians did not show statistically significant reductions in overall medical costs. We need new classifications for the kinds of mental disorders seen in primary care settings.
Notes
Comment In: Gen Hosp Psychiatry. 1990 Jan;12(1):8-102295438
PubMed ID
2295431 View in PubMed
Less detail

Equity in the use of publicly subsidized psychotherapy among elderly Danish cancer patients--a register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature118016
Source
Acta Oncol. 2013 Feb;52(2):355-63
Publication Type
Article
Date
Feb-2013
Author
Annika B von Heymann-Horan
Pernille E Bidstrup
Luise C Kristiansen
Anja Olsen
Klaus K Andersen
Peter Elsass
Christoffer Johansen
Susanne O Dalton
Author Affiliation
Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark. heymann@cancer.dk
Source
Acta Oncol. 2013 Feb;52(2):355-63
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Female
Financing, Government - statistics & numerical data - utilization
Healthcare Disparities - statistics & numerical data
Humans
Male
Middle Aged
Neoplasms - epidemiology - psychology - rehabilitation
Psychotherapy - economics - statistics & numerical data
Questionnaires
Registries
Abstract
Approximately 30% of cancer patients suffer from psychological distress, and psychotherapy has been shown to be effective in alleviating it. Based on the 'Behavioral Model of Health Service Use', we investigated equity in the use of publicly subsidized psychotherapy in a cohort of Danish cancer patients. We present descriptive data on patients' use of psychotherapy and examine characteristics of those who used this service.
The study population comprised 3646 participants in the prospective Diet, Cancer and Health cohort, diagnosed with a first cancer between 2003 and 2009, aged 56-80 years. Data on cancer diagnosis, psychotherapy use and comorbid conditions were obtained from registers, whereas data on demographics, social support and health status were obtained from questionnaires. Cox proportional hazards regression was used to identify factors related to use, which were subsequently evaluated with regard to equity.
Subsidized psychotherapy was used by 2.3% of the cancer patients. Longer education (> 10 years compared to 74 years: 0.07, 0.01-0.57, compared to
PubMed ID
23244710 View in PubMed
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Fiscal and service analyses in general hospital psychiatry.

https://arctichealth.org/en/permalink/ahliterature233156
Source
Can J Psychiatry. 1988 May;33(4):279-84
Publication Type
Article
Date
May-1988
Author
S A Kline
H. Moldofsky
Author Affiliation
Department of Psychiatry, University of Toronto, Ontario.
Source
Can J Psychiatry. 1988 May;33(4):279-84
Date
May-1988
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Fees, Medical - trends
Female
Health Services Needs and Demand - economics
Hospitals, General - economics
Humans
Male
Ontario
Psychiatric Department, Hospital - economics
Psychophysiologic Disorders - therapy
Psychotherapy - economics
Referral and Consultation - economics
Sick Role
Abstract
Fiscal matters were analyzed in four specialized programmes of the Department of Psychiatry at the Toronto Western Hospital in order to plan for service and academic activities. The resultant analysis allowed for the establishment of criteria for growth and the evaluation of clinical service performance and goals.
PubMed ID
3133100 View in PubMed
Less detail

Frame disturbances in no-fee psychotherapy.

https://arctichealth.org/en/permalink/ahliterature243622
Source
Int J Psychoanal Psychother. 1982-1983;9:135-46
Publication Type
Article
Author
J. Paris
Source
Int J Psychoanal Psychother. 1982-1983;9:135-46
Language
English
Publication Type
Article
Keywords
Adult
Canada
Fees and Charges
Humans
Insurance, Psychiatric
Male
Patient Discharge
Patient Dropouts - psychology
Professional-Patient Relations
Psychoanalytic Theory
Psychotherapy - economics
Abstract
The frame of psychotherapy shows both universality and social relativity. Since the intrapsychic world is permeable to social reality, the meaning of insurance in psychotherapy depends on context. Experience with Canadian National Health Insurance suggests that when no-fee psychotherapy in normative, it is absorbed in the frame. There are still trouble spots in the Canadian system, particularly the management of missed sessions. Depending on the needs of the patient, charging for missed sessions can disrupt therapy entirely or be constructive for the treatment.
PubMed ID
7152812 View in PubMed
Less detail

On direct patient participation in the cost of their psychiatric care. Part I. A review of the empirical and experimental evidence.

https://arctichealth.org/en/permalink/ahliterature238974
Source
Can J Psychiatry. 1985 Apr;30(3):178-83
Publication Type
Article
Date
Apr-1985
Author
N. el-Guebaly
H. Prosen
W. Bebchuk
Source
Can J Psychiatry. 1985 Apr;30(3):178-83
Date
Apr-1985
Language
English
Publication Type
Article
Keywords
Canada
Financing, Government
Financing, Personal
Health Policy
Health Services Accessibility - economics
Humans
Mental Health Services - economics
Patient Participation
Psychoanalytic Interpretation
Psychotherapy - economics
Abstract
In the midst of a sociopolitical debate regarding access to health services, an evaluation is required of the therapeutic impact of the direct participation by some patients in the cost of their psychiatric treatment. Empirical clinical concepts regarding the need for a direct payment of treatment by the patient have evolved. Initial rigorous practice systems have lead to more flexible methods allowing for the recognition of third-party financing. Psychoanalytic theory has addressed the issue most extensively, but other conceptual frameworks have reached similar conclusions as well. The experimental evidence to either support or refute the position that the direct payment of a fee has a beneficial effect on therapeutic outcome remains limited. The focus has been on studying the impact of fee manipulation, but a tested correlation of other motivators such as patient's insight, therapist's attitudes and behaviour and social pressures is mostly lacking. Two patient populations appear to be delineated. Fee participation is of particular value to the financially secure and to the educated while patients in need of less intensive involvement, with reality testing disturbance and limited insight benefit particularly from third party insurance. Different patient populations should have the right to choose different payment options.
PubMed ID
3995463 View in PubMed
Less detail

Program evaluation as a measure of the quality of a new approach to community psychiatric care.

https://arctichealth.org/en/permalink/ahliterature227568
Source
Qual Assur Health Care. 1991;3(4):247-55
Publication Type
Article
Date
1991
Author
J A Smylie
B L Calvert
G J Gerber
Author Affiliation
Brockville Psychiatric Hospital, Ontario, Canada.
Source
Qual Assur Health Care. 1991;3(4):247-55
Date
1991
Language
English
Publication Type
Article
Keywords
Adult
Community Mental Health Services - economics - standards
Costs and Cost Analysis
Efficiency
Female
Hospitals, Psychiatric - economics - utilization
Humans
Inpatients
Male
Mental Disorders - rehabilitation
Middle Aged
Ontario
Outpatients
Patient Admission - statistics & numerical data
Patient Satisfaction - statistics & numerical data
Program Evaluation
Psychotherapy - economics - methods
Quality Assurance, Health Care
Quality of Life
Referral and Consultation - statistics & numerical data
Abstract
The effectiveness of a new approach to providing psychiatric rehabilitation services in community settings will be assessed using a combination of quality assurance principles and program evaluation techniques. A new Assertive Community Rehabilitation Program (ACRP) is evaluated and compared with existing hospital rehabilitation programs. Measures of service efficiency, admission, discharge and readmission rates, and service costs are made for 100 new referrals, 99 inpatients and 117 outpatients. Follow-up interviews use standardized measures of clients' quality of life, clinical status, client and staff satisfaction, and community resource utilization. After 19 weeks of operation, the ACRP has prevented more admissions, and discharged more inpatients than the comparison programs. Readmission rates have not differed. Results at the end of the one-year project using this program-based quality assurance approach will facilitate managerial decisions about the future of rehabilitation services.
PubMed ID
1790323 View in PubMed
Less detail

Relapse of hospitalism: coming full circle or squaring one?

https://arctichealth.org/en/permalink/ahliterature219672
Source
Can J Psychiatry. 1993 Dec;38(10):695
Publication Type
Article
Date
Dec-1993

14 records – page 1 of 2.