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APHA Scientific Session and Event Listing

Sungeun Lee, School of Social Policy and Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, 215.898.5511, selee73@hotmail.com and Aileen Rothbard, ScD, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Room 3014, Philadelphia, PA 19104.

Objective: This study was a 14 year follow-up examining behavioral and healthcare utilization and costs of 206 individuals discharged from a state hospital in 1988. The purpose was to examine the type and extent of community mental health service use and to compare community costs to an institutional setting. Method: Almost all of the study subjects were long-stay patients discharged from a state psychiatric hospital and placed in community settings. A longitudinal integrated database on all mental health and medical services reimbursed by Medicaid as well as state-and-county-funded services was used to construct service utilization and unit cost measures. Results: During 2002, 14% of the subjects were admitted to an acute care psychiatric unit an average of 54 days per year compared to 1992 (17%, 48 days). Almost all of the subjects (94% vs 70% in 1992) received some form of outpatient mental health care and residential services (75% vs 74% in 1992). The total treatment cost per subject was approximately $71,000 in 2002 dollars compared to $61,433 in 1992. The estimated cost of state hospitalization in 2002 would have been 150,000 per year if persons had remained institutionalized. Conclusions: This analysis suggests that most state hospital patients are able to live in residential settings while receiving community outpatient treatment and case management services at a reduced cost.

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