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Predictors and Outcomes of Outpatient Mental Health Care

A 4-Year Prospective Study of Elderly Medicare Patients With Substance Use Disorders

Bibliographic Data

ID9103627
AuthorsPenny L Brennan (0000-0002-2914-2753, VA Palo Alto Health Care System, corresponding author), Christopher R Kagay, Jeffrey Geppert, Jeffrey J Geppert, Rudolf H Moos (corresponding author)
Year2001
Volume39
Issue1
Pages39-49
Publication date2001-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-200101000-00006
PMID11176542
OpenAlexW2032569054
LanguageEN
Citations received2
References cited21

BACKGROUND: Many elderly inpatients have substance use disorders; recent treatment guidelines suggest that they should receive regular outpatient mental health care after discharge from hospital. OBJECTIVE: The prevalence, predictors, and outcomes of outpatient mental health care obtained by elderly Medicare patients with substance use disorders were examined. RESEARCH DESIGN: A longitudinal prospective follow-up was performed. SUBJECTS: Data from Medicare Provider Analysis and Review Record and Part B Medicare Annual Data were used to identify elderly inpatients with substance use disorders (n = 4,961) and determine their outpatient mental health care 4 years following hospital discharge. RESULTS: Only 12% to 17% of surviving elderly substance abuse patients received outpatient mental health care in each of 4 years after discharge. Cumulatively over 4 years, approximately 18% of surviving patients obtained diagnostic/evaluative mental health services, 22% obtained psychotherapy, and 9% received medication management. Of patients who obtained outpatient mental health care, 57% made 10 or fewer outpatient mental health visits over the entire 4 years. Younger, non-black, and female patients were more likely to obtain mental health outpatient care, as were patients with prior substance-related hospitalizations, dual diagnoses, and fewer medical conditions. Prompt outpatient mental health care was predictively associated with higher likelihood of mental health readmissions and, among patients with drug disorders, lower mortality. CONCLUSION: Very few elderly Medicare substance abuse patients obtain outpatient mental health care, perhaps because of health or economic barriers

Ambulatory care · Health care · Inpatient care · Longitudinal study · Mental health · Outpatient clinic · Psychiatry · Substance abuse · Alcoholism and Thiamine Deficiency · Internal Medicine · Medicine · Opioid Use Disorder Treatment · Substance Abuse Treatment and Outcomes

  • Variation in Utilization of Health Care Services for Rural VA Enrollees With Mental Health‐Related Diagnoses

    Open Access•Christopher E Johnson, Ruth L Bush et al.•The Journal of Rural Health•2015

  • Predisposing Characteristics, Enabling Resources and Need as Predictors of Utilization and Clinical Outcomes for Veterans Receiving Mental Health Services

    DiJon R Fasoli, Mark E Glickman et al.•Medical Care•2010

  • Medicare's Mental Health Benefits

    Open Access•Jeremie J Sherman•Journal of Aging and Health•1996

  • A description of the extreme aged population based on improved medicare enrollment data

    Open Access•Bert Kestenbaum•Demography•1992

Unique citing works2
Citations per year0,13
Citation span2010 - 2015 (6)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2

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