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Managed Behavioral Health Care Patients and Their Nursing Care Problems, Level of Functioning, and Impairment on Discharge

University of California Los Angeles Neuropsychiatric Institute and Hospital and Assistant Dean of Clinical Affairs at the University of California Los Angeles School of Nursing

Gwen van Servellen, RN, PhD, FAAN

University of California Los Angeles and the Director of Nursing Research and Program Evaluation at the University of California Los Angeles Neuropsychiatric Institute and Hospital

Mary-Lynn Brecht, PhD

Principal Statistician at the University of California Los Angeles School of Nursing

BACKGROUND: Anecdotal reports of the effects of managed care restrictions suggest an erosion of medical and nursing care. Yet, few substantive data are available to indi cate that patients fare better or worse.

OBJECTIVES: To identify the characteristics of a large hospital's managed behavioral health population in relation to observed nursing care needs, level of patient function ing on admission and discharge, and length of stay.

STUDY DESIGN: A retrospective medical chart review was conducted on inpatients under managed behavioral health care contracts admitted and discharged between April 1995 and January 1996.

RESULTS: On discharge, patients showed improvement on all behavioral subsystem rat ings, with statistically significant differences in dependency, affiliative, aggressive- protective, achievement, and restorative subsystems. Patients with longer stays were significantly more impaired than patients with shorter stays on discharge Global As sessment of Functioning scores.

CONCLUSION: Expansion of the database to derive meaningful conclusions about the impact of managed care on the resolution of nursing care problems is discussed. (J Am Psychiatr Nurses Assoc [1998]. 4, 57-66)

Journal of the American Psychiatric Nurses Association, Vol. 4, No. 2, 57-66 (1998)
DOI: 10.1177/107839039800400207


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