Characteristics and Service Use Patterns of Nonelderly Medicare Beneficiaries With Schizophrenia

Yanos, Philip T.; Crystal, Stephen; Kumar, Rizie; Walkup, James

doi:10.1176/appi.ps.52.12.1644

Cited by 12 publications

(8 citation statements)

References 11 publications

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“…19,20 They are also consistent with the PORT conformance study results 21,22 that showed considerably higher rates for antipsychotic medications than for psychosocial treatments. While conformance to PORTrecommended antipsychotic use is similar in both studies (87.1% vs 89.2%-92.3% in the PORT), the outpatient psychotherapies differ: in fiscal years 1994 to 1996, the overall proportion receiving individual and/or group psychotherapy was 61.4% in this study compared with 45.0% in the PORT conformance study, but after 1996 the proportion decreased to 28.6% overall.…”

Section: Limitations and Strengthssupporting

confidence: 78%

The Effect of a Managed Behavioral Health Carve-Out on Quality of Carefor Medicaid Patients Diagnosed as Having Schizophrenia

Busch

Frank²,

Lehman³

2004

Arch Gen Psychiatry

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Context: Managed behavioral health carve-outs (MBHCOs) are a regular feature of public and private mental health care systems and have been successful in reducing costs. The evidence on quality impacts is limited and suggests comparable quality overall, except that people with severe psychiatric disorders may be those most disadvantaged by MBHCOs.Objective: To explore the effect of implementing an MBHCO on the quality of outpatient care received by enrollees diagnosed as having schizophrenia. ). The carve-out was negatively associated with receiving any individual therapy (OR, 0.27; 95% CI, 0.22-0.33), group therapy (OR, 0.19; 95% CI, 0.14-0.25), and psychosocial rehabilitation (OR, 0.31; 95% CI, 0.26-0.38). Family therapy occurred for less than 1% of this population in both carve-out and integrated regions. Conclusions:The MBHCO was not associated with changes in medication quality (for which it was not at financial risk). It was significantly associated with sharp decreases in the likelihood of receiving psychosocial treatments (for which it was financially at risk)-independent of whether a clinical evidence base supported them.

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Section: Limitations and Strengthssupporting

confidence: 78%

The Effect of a Managed Behavioral Health Carve-Out on Quality of Carefor Medicaid Patients Diagnosed as Having Schizophrenia

Busch

Frank²,

Lehman³

2004

Arch Gen Psychiatry

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“…Regarding dual eligibility enrollment, a previous study by Yanos (2001), using Medicare Current Beneficiary Survey data, found that the use of antipsychotic medication was significantly greater among dually enrolled individuals than among those who were enrolled in Medicare only. Our findings add to this previous work by suggesting differences in medication compliance may exist between beneficiaries dually enrolled and beneficiaries non-dually enrolled.…”

Section: E16mentioning

confidence: 99%

“…Thus, we still need to identify factors that may explain why patients do not take their medications. Jin, Sklar, Min Sen Oh, & Chuen, 2008;Hertz, Unger, & Lustik, 2005;Yu, Nicol, Yu, & Ahn, 2005;Obisesan, Vargas, & Gillum, 2000;Yanos, 2001;Sherman et al, 2009;Billups, Malone, & Carter, 2000;Schmittdiel et al, 2009). For the Part D population, current studies assessing the effect of Part D on medication compliance have typically focused on patient OOP costs (Schmittdiel et al, 2009 Our primary research objective was to assess non-compliance among Medicare Part D recipients for eight therapeutic classes of cardiovascular medication classes: antianginals, antihypertensives, antiarrhythmics, antihyperlipidemics, beta blockers, calcium channel blockers, cardiotonics, and diuretics.…”

Section: Introductionmentioning

confidence: 99%

Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Blackwell

Baugh²,

Montgomery³

et al. 2011

MMRR

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OBJECTIVES:(1) to assess non-compliance among Medicare Part D recipients for the cardiovascular medication classes; (2) to identify the probability of noncompliance for each medication class when controlling for the potential risk factors of age, gender, race/ethnic origin, census region, disease burden, dual eligibility enrollment status, Part D plan status, relative out-of-pocket (OOP) non-class costs, and relative OOP daily class costs.

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“…Cross-sectional studies have demonstrated a positive association between having adequate health insurance coverage and/or medication benefits and the use of services such as antipsychotic medication and outpatient services (McAlpine & Mechanic, 2000;Rabinowitz, Bromet, Lavelle, Hornak, & Rosen, 2001;Rabinowitz et al, 1998;Yanos, Crystal, Kumar, & Walkup, 2001). Particularly compelling evidence for this relationship also comes from a time-series study showing that changes in local mental health policy can have a direct negative impact on psychotropic medication use (Soumerai, McLaughlin, Ross-Degnan, Casteris, & Bollini, 1994).…”

Section: Enduring Environmental Conditions and Copingmentioning

confidence: 99%

Determinants of functioning and well-being among individuals with schizophrenia: An integrated model

Yanos

Moos

2007

Clinical Psychology Review

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Outcomes for health conditions are typically the result of multiple factors; however, studies tend to focus on a narrow class of variables. Functioning and well-being outcomes for schizophrenia are diverse and have resisted simple explanation; however, prior research has not offered an integrated understanding of the relative contributions of enduring and episodic environmental factors, personal resources and psychiatric factors, and cognitive appraisal and coping, on functioning and well-being outcomes in schizophrenia. The present article sets out an integrated model of the determinants of functioning and well-being among individuals with schizophrenia. To examine evidence that bears on the model, literature on hypothesized relationships is reviewed to identify areas for which there is strong evidence and areas where more research is needed. The article suggests areas for further research, and directs researchers and practitioners toward areas of intervention that can enhance functioning and well-being for persons diagnosed with schizophrenia.

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Characteristics and Service Use Patterns of Nonelderly Medicare Beneficiaries With Schizophrenia

Abstract: The findings were consistent with the hypothesis that Medicare financing, which restricts access to many mental health services, is not conducive to good community care for persons with schizophrenia.

Cited by 12 publications

References 11 publications

The Effect of a Managed Behavioral Health Carve-Out on Quality of Carefor Medicaid Patients Diagnosed as Having Schizophrenia

The Effect of a Managed Behavioral Health Carve-Out on Quality of Carefor Medicaid Patients Diagnosed as Having Schizophrenia

Noncompliance in the Use of Cardiovascular Medications in the Medicare Part D Population

Determinants of functioning and well-being among individuals with schizophrenia: An integrated model

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