Abstract：
:Many general hospitals are confronting issues of financial strain precipitated to a large extent by Medicare payment reductions. The viability of psychiatry programs within general hospitals more than ever depends upon some demonstration of their financial as well as clinical contribution. The aim of this study is to review some of the basic parameters governing Part A (hospital) Medicare reimbursement of DRG-exempt general hospital psychiatry units and to provide options for improving their financial viability. There are a number of specific mechanisms involved in managing Medicare cost and reimbursement. Establishing a system for gatekeeping is important because significant control of payor mix and length of stay resides with the unit gatekeeper. Establishing liaison for short-stay patients with nursing home papers is important because Medicare pays on a target cost per discharge. The identification of short-stay patients is financially very favorable, and often critical to balance the unavoidable longer-stay patients. This paper also discusses how medical-psychiatric units can interface most effectively with medical-surgical units. Finally, there is some discussion of the need to develop pre- and postadmission outpatient medical-psychiatric programs. The financial aspects of medical-psychiatry care, if not the increasing scrutiny of managed care, will force further development of such outpatient programs.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Goldberg RJ,Simundson Sdoi
10.1016/0163-8343(91)90035-usubject
Has Abstractpub_date
1991-09-01 00:00:00pages
313-8issue
5eissn
0163-8343issn
1873-7714pii
0163-8343(91)90035-Ujournal_volume
13pub_type
杂志文章abstract：:Nonmedical psychotherapists are able to present themselves to the public as psychiatrist-equivalents, except for prescribing drugs, because psychiatrists have neglected to emphasize the nature of medical responsibility, here called "medical primacy." Psychiatric identification with the psychoanalytic and public relati...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(79)90029-x
更新日期：1979-09-01 00:00:00
abstract：OBJECTIVE:This study aimed at determining the prevalence of psychosis in tuberculosis (TB) patients in comparison to nontuberculosis control and its correlation with disease pattern. METHOD:One hundred and fifteen patients with TB and 112 family members visiting the multidrug treatment-resistant treatment center at Un...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.05.012
更新日期：2015-11-01 00:00:00
abstract：OBJECTIVE:Persons with thoughts of self-harm may need evaluation for suicide risk. We examine the prevalence of thoughts of self-harm and whether persons with thoughts of self-harm are identified when two-stage depression screening is used. METHODS:Data are from the 2005-2010 National Health and Nutrition Examination ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2013.09.007
更新日期：2014-01-01 00:00:00
abstract：OBJECTIVE:This prospective study investigates the relationships between depressive symptoms, psychiatric medication use, and their interaction on risk of developing type 2 diabetes. METHOD:Data come from the 1998-2010 waves of the Health and Retirement Study, a US nationally representative cohort of adults aged 51 yea...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.05.008
更新日期：2015-09-01 00:00:00
abstract：:This article illustrates how a mandatory consult procedure identified treatable psychiatric problems. Using a computerized data-based format, 372 (37.4%) patients (the "judgment" group) of 996 psychiatric consultations were identified as referred to assess the patient's capacity to execute a consent form for a medical...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90074-x
更新日期：1985-07-01 00:00:00
abstract：:In the Netherlands, the prescription of beta-blockers to patients older than 70 years has increased sharply in recent years. The neuropsychiatric adverse reactions associated with the use of beta-blockers are relatively uncommon and they are mostly seen with poisoning or overdose. We describe an 81-year-old man who de...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.04.008
更新日期：2010-11-01 00:00:00
abstract：:A 32-year-old female with a seven year history of multiple sclerosis was hospitalized due to an exacerbation of symptoms, and complained of a high frequency of urination and occasional urinary incontinence. A urologic consult was obtained and the patient was diagnosed as having neurogenic (spastic) bladder, resulting ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(82)90022-6
更新日期：1982-04-01 00:00:00
abstract：OBJECTIVE:To determine whether a smartphone application (app) with an electronic headache diary and a progressive muscle relaxation (PMR) intervention is feasible and acceptable to people presenting to the Emergency Department (ED) with migraine. METHODS:This single arm prospective study assessed feasibility by actual...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2020.12.009
更新日期：2021-01-08 00:00:00
abstract：OBJECTIVE:Despite a good prognosis, the typically young age at diagnosis and physical sequelae may cause psychological distress in germ cell tumor survivors. We aimed to determine the frequency of anxiety and depression and analyze the impact of demographic and disease-related factors. METHOD:We enrolled N=164 testicu...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.09.001
更新日期：2016-01-01 00:00:00
abstract：:The psychiatric literature on competency indicates that a diagnosable psychiatric condition alone does not imply incompetency to make treatment decisions. Nonetheless, it is frequently assumed that individuals who are either mentally retarded or demented are incompetent to make decisions. The authors, focusing on the ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(88)90060-6
更新日期：1988-11-01 00:00:00
abstract：:Use of physiological data displayed on Intensive Care Unit (ICU) monitors can be a valuable adjunct for the consulting psychiatrist interviewing a resistant post ingestion patient. Directing the patient's awareness to his own physiological responses at moments of repressed affect can aid in penetrating dense denial of...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(80)90107-3
更新日期：1980-03-01 00:00:00
abstract：OBJECTIVE:This study examined if associations between body mass index (BMI) and mental and physical health were independent of genetic and familial factors. METHOD:Data from 2831 twins (66% female) were used in an epidemiological co-twin control design with measures of BMI and mental and physical health outcomes. Gene...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2013.04.004
更新日期：2013-09-01 00:00:00
abstract：:The author reviews moral arguments supporting a right to medical care, as well as empirical data concerning the effects of mental illness on society, and explores their relevance to a rights-based claim to mental health care. He concludes that there is ample ethical justification for a right to mental health care, giv...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/s0163-8343(99)00047-x
更新日期：2000-01-01 00:00:00
abstract：:This report describes the background, rationale, and research plan for a comparative treatment trial of the effectiveness of paroxetine, problem-solving therapy (PST-PC), and placebo in the treatment of minor depression and dysthymia in primary care patients. Patients were recruited from a variety of primary care prac...
journal_title：General hospital psychiatry
pub_type： 临床试验,杂志文章,随机对照试验,评审
doi：10.1016/s0163-8343(99)00023-7
更新日期：1999-07-01 00:00:00
abstract：:Suicidal behavior is disproportionately frequent among inner-city Hispanic adolescent girls. In an attempt to generate a multifactorial set of hypotheses to explain this behavior, 33 such subjects consecutively admitted for suicidal behavior and 15 demographically identical nonsuicidal subjects were assessed by means ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(91)90009-l
更新日期：1991-01-01 00:00:00
abstract：:Alcohol use disorders (AUDs) are common among inpatients in general hospitals and often cause excess mortality. This study investigates the prevalence of AUDs among nonpsychiatric inpatients in one general hospital and evaluates the ability of medical staff to identify such morbidity. A two-phase case-identification s...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2004.01.001
更新日期：2004-05-01 00:00:00
abstract：OBJECTIVE:Integrating primary care services into specialty mental health clinics has been proposed as a method for improving health care utilization for medical conditions by adults with serious mental illness. This paper examines the impact of a mental health based primary care program on emergency department (ED) vis...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.02.008
更新日期：2018-01-01 00:00:00
abstract：:Bromocriptine, an ergot alkaloid dopamine agonist, is a recent common treatment for suppression of lactation in postpartum women. A case is presented of a postpartum woman prescribed bromocriptine for suppression of lactation who developed hypertension, headaches, blurry vision, seizures, and pituitary hemorrhage. Dif...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(91)90131-f
更新日期：1991-07-01 00:00:00
abstract：OBJECTIVE:Optimism is prospectively and independently associated with superior cardiac outcomes, but there has been minimal study of optimism-specific interventions in persons with cardiovascular illness. We aimed to examine the feasibility and impact of an optimism-promoting program among patients with heart disease i...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2017.12.004
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVE:Primary care providers are increasingly taking on the role of ad hoc mental health provider. However, before patients in primary care can be treated, they must be identified. This study set out to validate a very brief screening instrument for identifying primary care patients with anxiety and depression. ME...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2005.08.010
更新日期：2006-03-01 00:00:00
abstract：OBJECTIVE:Physical activity (PA) following surgery for breast cancer may improve depressive symptoms and quality of life (QoL) via reduction in fatigue-related daily interference (FRDI). Less is known about how change in PA may relate to these psychosocial factors throughout the course of treatment. In a secondary anal...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2017.05.007
更新日期：2017-11-01 00:00:00
abstract：OBJECTIVE:The objective was to estimate the prevalence of both dementia and depression among community-dwelling older Americans and to determine if hospitalization is independently associated with dementia or depression in this population. METHOD:This cross-sectional study utilized data from a nationally representativ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2013.11.008
更新日期：2014-03-01 00:00:00
abstract：:We assessed differences in the referral rates of African-American and Caucasian elderly for geropsychiatric consultation. Reasons for referral, assigned diagnoses, and interventions made were also compared. A retrospective chart review of psychiatric consultations was completed for patients aged 65 years and older for...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(97)00004-2
更新日期：1997-05-01 00:00:00
abstract：:As part of a population study on the prevalence of psychopathology, users of "Over-The-Counter" Psychotropics (OTC-Ps) were studied. First, their mental health profile was examined by a number of subjective and objective assessments. Second, the medical consumption of the users was studied with special attention to th...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(00)00078-5
更新日期：2000-07-01 00:00:00
abstract：:The authors explore the difficulties present in the capacity evaluation of patients with strong religious beliefs. The article reviews the legal protection for treatment refusal on religious grounds as well as psychiatry's approach to religion. Clinical cases encountered in an urban hospital are presented to highlight...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(96)00003-5
更新日期：1996-05-01 00:00:00
abstract：:The variability in estimated rates of major depressive disorder (MDD) in chronic pain samples may be accounted for by sample and methodological differences. Most studies rely on a single measure of depression and lack independent or repeated measures. This study investigated the prevalence of psychiatric disorders in ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(95)00088-7
更新日期：1995-11-01 00:00:00
abstract：OBJECTIVE:Previous epidemiologic studies have documented a link between anxiety disorders and ulcer among adults. Few studies have examined these associations over time and little is understood about the pathways underlying these relationships. METHOD:Data were drawn from n = 2101 adult participants in the Midlife Dev...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.07.005
更新日期：2014-11-01 00:00:00
abstract：OBJECTIVE:Psychogenic factors may play a contributory role in the development or persistence of lichen simplex chronicus (LSC). The objective of this study was to evaluate the psychiatric profile of patients with LSC including depression and dissociative experiences. METHOD:Dermatology outpatients with a LSC (n=30) we...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2007.01.006
更新日期：2007-05-01 00:00:00
abstract：OBJECTIVE:Losing an infant or fetus late in pregnancy, during birth or in the first year of life is a potentially traumatic event for parents. However, little is known about the factors contributing to chronic posttraumatic stress reactions in this population. The present study examined chronic posttraumatic stress dis...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2013.06.006
更新日期：2013-11-01 00:00:00
abstract：INTRODUCTION:Intimate partner violence (IPV) is a common form of violence experienced by pregnant women and is believed to have adverse mental health effects postnatally. This study investigated the association of postnatal depression (PND) and suicidal ideation with emotional, physical and sexual IPV experienced by wo...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.10.005
更新日期：2016-01-01 00:00:00
