The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #53189

Victoria J. Vigil, MPH, CHES, CPHQ, Eric G. Hamilton, MS, and Christy L. Beaudin, PhD, MSW, CPHQ. Quality Improvement/Quality Measurement and Research, PacifiCare Behavioral Health, 5990 Sepulveda Blvd., Suite 400, Van Nuys, CA 91411, (818) 623-5984, victoria.vigil@phs.com

This study examines the impact of an enhanced care management program on the use of mental health services in a managed behavioral healthcare delivery system The program fosters improved community functioning for severely mentally ill service users by facilitating engagement with a range of outpatient resources. The program includes traditional case management components of case finding, assessment, planning, connecting, monitoring, and advocacy. However, in contrast to many public sector programs, the care managers in this program act as brokers and do not provide services directly. The care experiences of 197 plan members were analyzed before and after enrollment in the program. Key study findings include: (1) hospital admissions following enrollment in the program were significantly reduced; (2) program participation did not lead to a significant increase in overall outpatient service utilization; and (3) program participation for at least six months lead to a significant increase in outpatient service utilization. These findings suggest that a vigorous, system agent model of care management can be effective in maintaining community-based care for persons with severe and persistent mental illness.

Learning Objectives:

• The audience will learn about an alternative strategy for managing community-based care for persons with chronic mental health disorders, will understand how the use of such a the program can affect inpatient and ambulatory service utilization, and will recognize how such a program is applicable for wider use in public and private sector mental health services delivery.

Keywords: Mental Illness, Utilization

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: PacifiCare Behavioral Health
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employer

Handout (.doc format, 55.0 kb)