Studying inpatient treatment practices in schizophrenia: An integrated methodology
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
A multi-phase research project examining current impatient psychiatric practices and the relationships between different treatments and patient outcomes is described. The study sample includes Medicaid patients with a diagnosis of schizophrenia who have been treated in inpatient units of general hospitals in New York State. The research is focused at the heart of the debate concerning the appropriate role of inpatient psychiatric care within a balanced system of mental health services. Addressed are the conceptual issues that guided the project, research strategies, instrument development, measures used and the preliminary findings that informed successive phases. Design issues are reviewed in light of the conceptual and pragmatic decisions made with a multiple site design. A compelling argument is made about the need for a long-term treatment orientation that prepares patients for what lies ahead and that assures communication and continuity between inpatient and outpatient care.
- Mechanic, D: Organization of care and quality of life of persons with serious and persistent mental illness, in Quality of Life in Mental Disorders. Edited by Katschnig H, Freeman H, and Sartorius N. New York, John Wiley, 1995.
- Olfson M, Glick ID, Mechanic D: Impatient treatment of schizophrenia in general hospitals. Hospital and Community Psychiatry 44:40–44, 1993.
- New York State Office of Mental Health: Utilization Reports. Albany, Office of Mental Health, 1988–1992.
- Salit SA, Marcos LR: Have general hospitals become chronic care institutions for the mentally ill? American Journal of Psychiatry 148:892–897, 1991.
- Center for Research on the Organization and Financing of Care for the Severely Mentally Ill: Evaluation of the Consolidated Inpatient and Outpatient Psychiatric Rate Methodology: Final Draft Report. New Brunswick, NJ, Rutgers University, 1994.
- Boyer CA, Mechanic D: Psychiatric reimbursement reform in New York State: lessons in implementing change. The Milbank Quarterly 72:621–651, 1994.
- National Institute of Mental Health: Mental Health, United States, 1985. Edited by Taube CA, Barrett SA. Washington, DC, DHHS Pub. No. (ADM) 85-1378, 1985.
- Goldman HH, Skinner EA: Specialty mental health services: research on specialization and differentiation, in The Future of Mental Health Services Research. Edited by Taube CA, Mechanic D, Hohmann AA. Washington, DC, US Government Printing Office, 1989.
- Paul GL, Menditto AA: Effectiveness of inpatient treatment programs for mentally ill adults in public psychiatric facilities. Applied and Preventive Psychology 1:41–63, 1992. CrossRef
- Moos RH: Evaluating Treatment Environments: A Social Ecological Approach. New York, John Wiley, 1974.
- Bachrach LL: The concept of young adult chronic psychiatric patients: questions from a research perspective. Hospital and Community Psychiatry 35:573–580, 1984.
- Colson DB, Coyne L, Pollack WS: Scales to assess the emphasis of psychiatric hospital treatment. Psychiatry 51:281–290, 1988.
- Caton C, Koh S, Fleiss J, et al: Rehospitalization in chronic schizophrenia. Journal of Nervous and Mental Diseases 173:139–148, 1985.
- Olfson M, Hansell S, Boyer C, Walkup J, Mechanic D: The Routine Inpatient Treatment Scale for Schizophrenia (RITS-S): rationale and measurement characteristics. New Brunswick, NJ, Institute for Health, Health Care Policy and Aging Research, Rutgers University, 1993.
- Haas G, Glick ID, Clarkin J, et al: Inpatient family intervention: a randomized clinical trial. Archives of General Psychiatry 45:217–224, 1988.
- Glick ID, Clarkin J, Haas G, et al: A randomized clinical trial of inpatient family intervention: VI mediating variables and outcome. Family Process 30:85–99, 1991. CrossRef
- Drake R, Sederer L: Inpatient psychosocial treatment of chronic schizophrenia: negative effects and current guidelines. Hospital and Community Psychiatry 37:897–901, 1986.
- Caton C, Goldstein J, Serrano O, et al: The impact of discharge planning on chronic schizophrenic patients. Hospital and Community Psychiatry 35:255–262, 1984.
- Schooler NR, Keith SJ, Severe JB, et al: Acute treatment response and short term outcome in schizophrenia: first results of the NIMH Treatment strategies in schizophrenia study. Psychopharmacology Bulletin 25:331–335, 1989.
- Spitzer RL, Williams JBW, Gibbon M, et al: Structured Clinical Interview for DSM III R-Patient Edition (SCIP-P, Version 1.0). Washington, DC, American Psychiatric Association, 1990.
- Sheehan D, et al: Mini-International Neuropsychiatric Interview, Clinician Rated. Version 3.0. Miami, FL, University of South Florida, 1993.
- Radloff LS: The CES-D scale: a self report depression scale for research in the general population. Applied Psychological Measurement 1:385–401, 1977.
- Overall JE, Gorham DP: Brief Psychiatric Rating Scale- Anchored. (ADM): 9–90. Washington, DC, Department of Health and Human Services, 1984.
- Endicott J, Spitzer RL, Fleiss JL, et al: The global assessment scale. Archives of General Psychiatry 33:766–771, 1976.
- Lehman A: A Quality of Life Interview for the Chronically Mentally III- Shortened Version. Baltimore, University of Maryland, 1992.
- Rosenberg M: Conceiving the Self. Reprint edition. Melbourne, FL, Krieger, 1986.
- Pearlin LI, Lieberman MA, Menaghan EG, et al: The Stress Process. Journal of Health and Social Behavior 22:337–356, 1981.
- Rosenfield S: Factors contributing to the subjective quality of life of the chronically mentally ill. Journal of Health and Social Behavior 33: 299–315.
- Link BG, Cullen FT, Frank J, et al: The social rejection of former mental patients: understanding why labels matter. American Journal of Sociology 92:1461–1500, 1987. CrossRef
- Weiden P, Rapkin B, Mott T, et al: Rating of medication influences (ROMI) scale in schizophrenia. Schizophrenia Bulletin 20:297–310, 1994.
- Larsen DL, Attkisson CC, Hargreaves WA, et al: Assessment of client/patient satisfaction: development of a general scale. Evaluation and Program Planning 2:197–207, 1979. CrossRef
- Studying inpatient treatment practices in schizophrenia: An integrated methodology
Volume 66, Issue 4 , pp 293-320
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Human Sciences Press
- Additional Links
- Author Affiliations
- 1. Institute for Health, Health Care Policy and Aging Research, Rutgers University, 30 College Avenue, 08903, New Brunswick, NJ
- 2. Department of Psychiatry, Columbia University College of Physicians and Surgeons, USA