Racial/Ethnic Disparities in Admissions to Public and Private Psychiatric Inpatient Settings: The Effect of Managed Care
This study investigates the effect of managed care on access patterns among people of color who are severely and persistently mentally ill. The distribution of admissions to public and private psychiatric hospitals was compared for African-American, Asian, Latino, and white case managed clients of the Massachusetts Department of Mental Health before and after implementation of Medicaid managed mental health care in October 1997. Managed care appears to have increased access to private services across all racial and ethnic groups, although admissions of non-white patients were still more likely to take place in publicly operated settings. These data suggest that equalizing access to putatively better inpatient treatment settings may be an externality of managed care.
- Borenstein, D.B. (1990). Debate: Managed care: A means of rationing psychiatric treatment. Hospital & Community Psychiatry, 41, 1095-1098.
- Callahan, J.J., Shepard, D.S., Beinecke, R.H., Larson, M.J., & Cavanaugh, C. (1995). Mental health/substance abuse in managed care: The Massachusetts Medicaid experience. Health Affairs, 41, 173-184.
- Dickey, B., Normand, S.L.T., Norton, E.C., Azeni, H., & Fisher, W.H. (1996). Managing the care of schizophrenia: Lessons from a four-year Massachusetts Medicaid Study. Archives of General Psychiatry, 53, 945-932.
- Dickey, B., Norton, E.C., Normand, S.L.T., Azeni, H., Fisher, W.H., & Altaffer, F. (1995). Massachusetts Medicaid managed health care reform: Treatment for the psychiatrically disabled. Advances in Health Economics and Health Services Research, 15, 99-116.
- Dorwart, R.A., & Epstein, S. (1993). Privatization and mental health care: A fragile balance. Westport, CT: Auburn House.
- Fisher, W.H., Dorwart, R.A., Schlesinger, M., Epstein, S., & Davidson, H. (1992). The role of general hospitals in the privatization of inpatient treatment for serious mental illness. Hospital & Community Psychiatry, 43, 1114-1119.
- Fisher, W.H., Lindrooth, R., Norton, E.C., & Dickey, B. (in press). How managed care organizations develop selective contracting networks for psychiatric inpatient care: A case study. Inquiry.
- Fisher, W.H., White, C.L., Geller, J.L., & Altaffer, F. (1994). Predicting public vs. private hospitalization in psychiatric emergencies. Adminstration and Policy in Mental Health, 21, 449-462.
- Hadley, T.R., Schinnar, A.R., & Rothbard, A. (1994). Managed mental health care in the private sector. In S. Feldman (Ed.), Managed mental health services (pp. 45-60). Springfield, IL: Charles C. Thomas.
- Hu, T., Snowden, L.R., Jerrell, J.M., & Nguyen, T.D. (1991). Ethnic populations in public mental health: Services choice and level of use. American Journal of Public Health, 81, 1429-1434.
- Joint Commission on Mental Illness and Health. (1961). Action for mental health. New York, NY: Basic Books.
- Krause, E.A. (1977). Power and illness: The political sociology of health and medical care. New York, NY: Elsevier
- Keill, S. (1980). Psychiatric care: A new role for hospitals. Hospitals, 54, 67-70.
- Lebensohn, Z. (1980). General hospital psychiatry USA: Retrospect and prospect. Comprehensive Psychiatry, 21, 500-509.
- Manderscheid, R.W., & Barrett, S.A. (Eds.). (1987). Mental health, United States, 1987 (DHHS Publication No. ADM 87-1518). Washington, DC: U.S. Government Printing Office.
- Minkoff, K. (1994). Community mental health in the nineties: Public sector managed care. Community Mental Health Journal, 30, 317-321.
- Robertson, S. (1974). Changing the medical care system. New York, NY: Praeger.
- Starr, P. (1982). The social transformation of American medicine. New York, NY: Basic Books.
- Stelovich, S. (1992). Managed care and major mental illness: An overview. In J.L. Feldman & R.J. Fitzpatrick (Eds.), Managed mental health care: Adminstrative and clinical issues (pp. 249-260). Washington, DC: American Psychiatric Press.
- Weimer, S.R. (1990). Managed mental health care: Myths and realities in the 1990s. Hospital & Community Psychiatry, 41, 1092-1098.
- White, C.L., Bateman, W.H., Fisher, W.H., & Geller, J.L. (1995). Factors associated with admission to public and private hospitals from a psychiatric emergency screening site. Psychiatric Services, 46, 467-472.
- Racial/Ethnic Disparities in Admissions to Public and Private Psychiatric Inpatient Settings: The Effect of Managed Care
Administration and Policy in Mental Health and Mental Health Services Research
Volume 26, Issue 2 , pp 101-109
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links