Spending On Mental Health And Substance Abuse Treatment, 1987–1997

Mark, Tami L.; Coffey, Rosanna M.; King, Edward C.; Harwood, Henrick J.; McKusick, David; Genuardi, Jim; Dilonardo, Joan; Buck, Jeffrey A.

doi:10.1377/hlthaff.19.4.108

Cited by 51 publications

(30 citation statements)

References 11 publications

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“…To date, information about changing patterns of MH/SA services has generally been limited to aggregate expenditures and short-term case studies of selected groups. 4 This study examines trends in inpatient and outpatient treatment, psychotropic drug use, access, and spending between 1987 and 1996. Particular attention is paid to trends by age (especially children and the elderly), sex, racial/ethnic subgroups, family income, and health insurance status.…”

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confidence: 99%

Trends In Mental Health Services Use And Spending, 1987–1996

Zuvekas¹

2001

Health Affairs

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confidence: 99%

Trends In Mental Health Services Use And Spending, 1987–1996

Zuvekas¹

2001

Health Affairs

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“…This pattern mirrors changes outside the VA, where managed care has had a greater impact on mental health inpatient use than on short-term hospitalizations for medical disorders. 11 Much of the savings from reduced inpatient care was offset by increases in outpatient and residential care. The expansion of residential care was associated with a decrease in daily costs.…”

Section: Discussionmentioning

confidence: 99%

“…13 Spending for VA mental health medications followed the general trend and was consistent with growth in mental health and substance abuse prescription costs of privately insured patients. 14 The sharp increase in pharmacy spending suggests that new treatment protocols and the introduction of new medications have tilted mental health spending in the direction of pharmacotherapy. For example, schizophrenia treatment in the late 1990s was marked by the introduction of several new antipsychotics and the increasing use of combination drug therapy.…”

Section: Discussionmentioning

confidence: 99%

Spending For Specialized Mental Health Treatment In The VA: 1995–2001

Chen¹,

Smith²

2003

Health Affairs

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ABSTRACT:The mid-1990s saw dramatic changes in mental health care in the Department of Veterans Affairs (VA), the largest provider of such care in the United States. Spending for specialized inpatient mental health care fell 21 percent from 1995 to 2001, while spending for specialized outpatient care rose 63 percent. The shift from inpatient to outpatient care was accompanied by rapid increases in outpatient medication costs. Overall, the VA reduced the average cost (per VA user) of specialized mental health care by 22 percent while it increased the number of users of these services by 35 percent.T h e d e pa rt m e n t o f v e t e r an s a f fa i r s (VA) provides health care to more than four million veterans annually. As the nation's largest provider of behavioral health services, the VA helps to define standards of care for U.S. mental health treatment.Several initiatives have transformed the agency since the mid-1990s. 1 The Veterans Eligibility Reform Act of 1996 liberalized eligibility rules and eliminated restrictions on outpatient care for low-income veterans. In 1997 the VA adopted a five-year plan to increase the number of veterans served by 20 percent and to decrease average per patient expenditure by 30 percent.2 The agency adopted the Veterans Equitable Research Allocation (VERA) system, a budget allocation method that gave regional networks strong incentives to serve more patients and to reduce per patient costs. The broader U.S. mental health care system was also changing. Among people with employment-based private insurance, overall spending for mental health and substance abuse treatment grew more slowly than general health care spending during 1992-1999. D a t a W a t c h

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“…While spending on psychotropic medications is increasing at a higher annual rate than is spending on other medications (17.1% vs. 12.1%) (10)(11). psychotropic drugs may still be underused in mental health care (12) due to barriers to treatment such as cost and stigma.…”

Section: Introductionmentioning

confidence: 99%

Who Are the New Users of Antipsychotic Medications?

Domino¹,

Swartz²

2008

Psychiatric Services

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Objective-to examine changes in the prevalence of antipsychotic medication use and the characteristics of antipsychotic users in the US population.Methods-We use data from the Medical Expenditure Panel Survey from 1996/97 and 2004/05 to examine the rate of first and second-generation antipsychotic medication use and changes in the characteristics of users of all ages. We examine trends in the level of use by antipsychotic users both in terms of daily dose units and number of prescriptions.Results-The rate of antipsychotic use has increased substantially between 1996/97 and 2004/05, but the average dose measured both by daily dose units and number of prescriptions has remained constant. The rapid diffusion of antipsychotic medications occurred not among individuals with schizophrenia, but rather includes substantial growth in off-label users and newer on-label conditions. Demographic, financial, and insurance characteristics of users have remained fairly constant, with few exceptions. The average age of antipsychotic users has declined from 1996-2005 as more children are using these medications. The gender, racial, ethnic, and insurance composition of users has been fairly stable over time, however.Conclusions-The rapid diffusion of second-generation antipsychotic medications was achieved by large increases in the rate of use in certain subpopulations, most notably children. Increasing understanding of the marginal efficacy and side-effect risks of newer and more expensive antipsychotic agents, even when prescribed as indicated, suggests that the dramatic increase in use warrants careful attention.

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Spending On Mental Health And Substance Abuse Treatment, 1987–1997

Cited by 51 publications

References 11 publications

Trends In Mental Health Services Use And Spending, 1987–1996

Trends In Mental Health Services Use And Spending, 1987–1996

Spending For Specialized Mental Health Treatment In The VA: 1995–2001

Who Are the New Users of Antipsychotic Medications?

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