Skip to main content
Log in

Predicting state vs. private hospital referral in psychiatric emergencies

  • Articles
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

Using data from a two-month observation of referrals (N=320) to state hospitals and private facilities from five prescreening sites in Massachusetts, the authors discuss a number of factors predictive of referral destination. Overall, the probability of referral to a state hospital was approximately 60% greater than to a privately owned facility. Patients who were married, non-threatening to self or others, and privately insured were more likely to be referred to private settings. In addition, a significant positive effect of regional private bed supply was identified.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Bachrach, L.L. (1981). General hospital psychiatry: Overview from a sociological perspective.American Journal of Psychiatry, 138, 879–887.

    Google Scholar 

  • Brown, P. (1985).The transfer of care. London: Routledge and Kegan-Paul.

    Google Scholar 

  • Crowder, J., & Klatte, E. (1980). Involuntary admissions to general hospitals: Legal status is not the issue.Hospital and Community Psychiatry, 31, 325–327.

    Google Scholar 

  • Dixon, W.J., Engleman, L., & Frane, J.W. (1989).BMDP statistical software. Berkeley, CA: University of California Press.

    Google Scholar 

  • Dorwart, R.A., & Schlesinger, M. (1988). The privatization of mental health services.American Journal of Psychiatry, 145, 543–553.

    Google Scholar 

  • Dorwart, R.A. Schlesinger, M., Davidson, H., Epstein, S., & Hoover C. (1991). A national study of psychiatric hospital care.American Journal of Psychiatry, 148, 204–210.

    Google Scholar 

  • Fisher, W.H., Altaffer, F., White, C.L., Geller, J.L. (1991). Inpatient services for the seriously mentally ill: Estimating the state hospital's “market share”.Proceedings of the second annual conference on state mental health agency services research (pp. 289–298). Arlington, VA: National Association of State Mental Health Program Directors Research Institute, Inc.

    Google Scholar 

  • Fisher, W.H., Dorwart, R.A., Schlesinger, M., & Davidson, H. (1991). Contracting between public agencies and private psychiatric inpatient facilities.Medical Care, 29, 766–774.

    Google Scholar 

  • Geller, J.L. (1991). “Anyplace but the state hospital”: Examining assumptions about the benefits of admission diversion.Hospital and Community Psychiatry, 42, 145–152.

    Google Scholar 

  • Goldman, H.H., Taube, C.A., & Jencks, S.F. (1987). The organization of the psychiatric inpatient service system.Medical Care, 25, 6–21.

    Google Scholar 

  • Greenhill, M. (1979). Psychiatric units in general hospitals: 1979.Hospital and Community Psychiatry, 30, 169–182.

    Google Scholar 

  • Hosmer, D., & Lemeshow, S. (1989).Applied logistic regression. New York, Wiley.

    Google Scholar 

  • Joint Commission On Mental Illness and Health. (1961).Action for metnal health. New York: Basic Books.

    Google Scholar 

  • Keill, S. (1981). Current issues in general hospital psychiatry: Introduction: The evolution of psychiatry in the general hospital.General Hospital Psychiatry, 3, 289–291.

    Google Scholar 

  • Leeman, C. (1980). The ‘least restrictive environment’: From rhetoric to practice.General Hospital Psychiatry, 3, 229–232.

    Google Scholar 

  • Leeman, C. (1980). Involuntary admissions to general hospitals: Progress or progress or threat?Hospital and Community Psychiatry 31: 315–318.

    Google Scholar 

  • Leeman, C., & Berger, H. (1980). The Massachusetts Psychiatric Society's position paper on involuntary psychiatric admissions to general hospitals.Hospital and Community Psychiatry, 31, 318–324.

    Google Scholar 

  • Moran, A., Freedman, R.I., & Sharfstein, S. (1984). The journey of Sylvia Frumkin: A case study for policymakers.Hospital and Community Psychiatry, 35, 887–893.

    Google Scholar 

  • Olfson, M. (1991). General hospitals and the severely mentally ill: Changing patterns of diagnosis.American Journal of Psychiatry, 148, 727–732.

    Google Scholar 

  • Rosenblatt, A. (1984). Concepts of the asylum in the care of the mentally ill.Hospital and Community Psychiatry, 35, 244–250.

    Google Scholar 

  • Salit, S.A., & Marcos, L.R. (1991). Have general hospitals become chronic care institutions for the mentally ill?American Journal of Psychiatry, 148, 892–897.

    Google Scholar 

  • Sheehan, S. (1982).Is there no place on earth for me? New York: Vintage Books.

    Google Scholar 

  • Wing, J.K. (1990). The functions of the asylum.British Journal of Psychiatry, 157, 822–827.

    Google Scholar 

  • Wolff, N., & Stone, M.R. (1988).The effects of hospital ownership form on access to inpatient mental health services: A case study of inpatients with schizophrenia. Paper presented at the Fifth Annual Meeting of the Foundation for Health Services Research, San Francisco CA.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fisher, W.H., White, C., Geller, J.L. et al. Predicting state vs. private hospital referral in psychiatric emergencies. Adm Policy Ment Health 21, 449–461 (1994). https://doi.org/10.1007/BF00707257

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00707257

Keywords

Navigation