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Impact of VA bed closures on use of state psychiatric services

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Abstract

This study examined whether inpatient bed reductions at a Department of Veterans Affairs (VA) medical center increased VA patients' use of state mental health agency services. Veterans residing in two Connecticut cities who used VA psychiatric services during fiscal years 1993 through 1998 (n =2,943) were identified from computerized files. Then their records were merged with state files. Coinciding with the time of VA bed closures, the proportion of VA patients who used any state services increased from 2.6%, 2.8%, and 2.7% from 1993 through 1995 to 3.6%, 3.5%, and 3.6% from 1996 through 1998 (p<.03). These changes reflect increased likelihood of state outpatient service use, but not inpatient services. No statistically significant changes occurred in the cost of state services used by VA patients. Bed closure impact may be reflected in increased cross-system service use, which may be a useful indicator of unmet needs resulting from system changes.

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Authors and Affiliations

  1. the Department of Veterans Affairs Northeast Program Evaluation Center, USA

    Robert Rosenheck MD (Director)

  2. the VISN 1 Mental Illness Research, Education, and Clinical Center, USA

    Robert Rosenheck MD (Director)

  3. Psychiatry in the Yale School of Medicine Departments of Psychiatry and Public Health (182), VA Connecticut Health Care System, 950 Campbell Avenue, 06516-2770, West Haven, CT

    Robert Rosenheck MD (Director)

  4. the Connecticut Department of Mental Health and Addiction Services, USA

    Linda Frisman PhD (Research Director)

  5. the University of Connecticut Department of Psychology, USA

    Linda Frisman PhD (Research Director)

  6. the Division of Health Services Research at the Mt. Sinai School of Medicine Department of Psychiatry, USA

    Susan Essock PhD (Professor and Director)

  7. the Department of Veterans Affairs VISN 3 Mental Illness Research, Education and Clinical Center, USA

    Susan Essock PhD (Professor and Director)

  8. The Connecticut Department of Mental Health and Addiction Services, USA

    Susan Essock PhD (Professor and Director)

Authors
  1. Robert Rosenheck MD
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  2. Linda Frisman PhD
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  3. Susan Essock PhD
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Correspondence to Robert Rosenheck MD.

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Rosenheck, R., Frisman, L. & Essock, S. Impact of VA bed closures on use of state psychiatric services. The Journal of Behavioral Health Services & Research 28, 58–66 (2001). https://doi.org/10.1007/BF02287234

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  • DOI: https://doi.org/10.1007/BF02287234

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