Costs of community-based public mental health services for older adults: variations related to age and diagnosis.

Costs of community-based public mental health services for older adults: variations related to age and diagnosis. Research Abstract Details 

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Costs of community-based public mental health services for older adults: variations related to age and diagnosis. Abstract Text:

Todd Gilmer,Victoria D Ojeda,David Folsom,Dahlia Fuentes,Viviana Criado,Piedad Garcia,Dilip V Jeste,

BACKGROUND: Several studies have examined service use among older adults although, to our knowledge, none has examined costs from a systems perspective. This study examined use and costs of mental health services among older adults in San Diego County in order to determine how expenditures and modes of service varied by age cohort and psychiatric diagnosis. METHODS: Utilization data from San Diego County Adult and Older Adult Mental Health Services (AOAMHS) were used to identify older adults (age > or = 60) receiving services in the community during fiscal year 2003-2004. Cost data were derived from detailed examination of cost reports, and Medicaid fee schedules. Trends in demographic and clinical characteristics by six age cohorts were described. Multivariate models were used to estimate the relationships between costs, age, and clinical diagnosis while controlling for other demographic and clinical characteristics. Components of costs were also examined. RESULTS: Total expenditures declined from age cohorts 60-64 through ages 85 and over. Expenditures were similar, and greatest, for clients with schizophrenia and bipolar disorder, while outlays were lower for those with major depression, other psychotic disorder, other depression, anxiety, substance use disorder, and cognitive disorders. Clients diagnosed with cognitive disorder had high use of emergency services and little connection to outpatient services. CONCLUSIONS: Expenditures were related to age and clinical diagnosis. Future efforts should investigate older adults' pathways to care, and should determine whether older adults presenting in emergency services would benefit from a specialized case management program providing linkages to community based resources.

Costs of community-based public mental health services for older adults: variations related to age and diagnosis. Publishing Authors By Initials

T Gilmer,VD Ojeda,D Folsom,D Fuentes,V Criado,P Garcia,DV Jeste,

For similar persons: age groups: adult: middle aged research abstracts see: persons: age groups: adult: middle aged research

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Costs of community-based public mental health services for older adults: variations related to age and diagnosis. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: International journal of geriatric psychiatry

VOLUME: 21

Page Numbers: 1121-6

Journal Abbreviation:

ISSN: 0885-6230

DAY: 3

MONTH: Dec

YEAR: 2006

Costs of community-based public mental health services for older adults: variations related to age and diagnosis. Information

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LANGUAGE: eng

NlmUniqueID: 8710629

Costs of community-based public mental health services for older adults: variations related to age and diagnosis. Keywords Mesh Terms:

KEYWORDS: Middle Aged

MESH TERMS: therapy

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Grant and Affiliation Information for Costs of community-based public mental health services for older adults: variations related to age and diagnosis.

AFFILIATION: Department of Family and Preventive Medicine, University of California, San Diego, CA 92093, USA. tgilmer@ucsd.edu

Country: England

AGENCY: United States NIMH

GRANT: T32-MH 019733-10

ACRONYM: MH

MEDLINETA: Int J Geriatr Psychiatry

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