A controlled study of the impact of brief, transitional acute care in reducing psychiatric treatment costs for people in rural areas is presented. Treatment emphasized home-based counseling and support, 24-hour rapid response, rural outreach, and intensive support management. The objective was to avert hospitalizations when possible, expedite discharge, and reduce likelihood of readmission, while maintaining comparable or superior clinical outcome. One-hundred eighty-two participants were randomly assigned to the experimental group or a routine care control group. Clinical and utilization data tracked at initial contact, 2 weeks, 6 months, and 12 months suggest substantially lower hospital utilization for the experimental group. Clinical outcomes were comparable between groups.
Chronic pain patients in the midst of litigation over settlement for their injuries were examined as a naturally occurring group where one might expect various distortions or differences in test findings on the Minnesota Multiphasic Personality Inventory-Revised (MMPI-2). Similar groups of 43 chronic pain patients in litigation and 45 not in litigation were examined on 10 key MMPI-2 variables selected a priori. Multivariate analysis of variance revealed a significant difference between groups (p = .036). Litigators were most distinct in endorsing more obvious and fewer subtle symptoms. A conversion profile was also more salient for litigators once the obvious versus subtle differences were taken into account. Implications for use of the MMPI-2 and for clinical work with litigious patients are examined.
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