Original Paper

Administration and Policy in Mental Health and Mental Health Services Research

, Volume 35, Issue 4, pp 231-240

First online:

Medicare Inpatient Treatment for Elderly Non-dementia Psychiatric Illnesses 1992–2002; Length of Stay and Expenditures by Facility Type

  • Donald R. HooverAffiliated withCenter for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes, Institute for Health, Health Care Policy and Aging Research (IHHCPAR) at Rutgers, The State University of New JerseyDepartment of Statistics and Biostatistics at Rutgers, The State University of New Jersey Email author 
  • , Ayse AkincigilAffiliated withCenter for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes, Institute for Health, Health Care Policy and Aging Research (IHHCPAR) at Rutgers, The State University of New JerseySchool of Social Work at Rutgers, The State University of New Jersey
  • , Jonathan D. PrinceAffiliated withCenter for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes, Institute for Health, Health Care Policy and Aging Research (IHHCPAR) at Rutgers, The State University of New JerseySchool of Social Work at Rutgers, The State University of New Jersey
  • , Ece KalayAffiliated withCenter for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes, Institute for Health, Health Care Policy and Aging Research (IHHCPAR) at Rutgers, The State University of New Jersey
  • , Judith A. LucasAffiliated withCenter for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes, Institute for Health, Health Care Policy and Aging Research (IHHCPAR) at Rutgers, The State University of New Jersey
  • , James T. WalkupAffiliated withCenter for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes, Institute for Health, Health Care Policy and Aging Research (IHHCPAR) at Rutgers, The State University of New JerseyGraduate School of Applied and Professional Psychology at Rutgers University, The State University of New Jersey
  • , Stephen CrystalAffiliated withCenter for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes, Institute for Health, Health Care Policy and Aging Research (IHHCPAR) at Rutgers, The State University of New Jersey

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Abstract

We summarize Medicare utilization and payment for inpatient treatment of non-dementia psychiatric illnesses (NDPI) among the elderly during 1992 and 2002. From 1992 to 2002, overall mean Medicare expenditures per elderly NDPI inpatient stay declined by $2,254 (in 2002 dollars) and covered days by 2.8. However, these changes are complicated by expanded use of skilled nursing facilities and hospital psychiatric units, and decreased use of long-stay hospitals and general hospital beds. This suggests that inpatient treatment for NDPI is shifting into less expensive settings which may reflect cost-cutting strategies, preferences for less restrictive settings, and outpatient treatment advances.

Keywords

Non-dementia psychiatric illnesses Inpatient care Expenditures Length of stay Elderly