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Article   |    
Use of Inpatient Psychiatric Care at a VA Medical Center After Implementation of a Prospective Payment System
Joan D. Dilonardo; Kathleen A. Kendrick; Larry A. Seitz
Psychiatric Services 1991; doi:
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The authors thank Sue Hudec, R.N., M.S., chief of the nursing service, and Stephen Deutsch, M.D., Ph.D., chief of the psychiatric service at the Veterans Affairs Medical Center in Washington, D.C.

Veterans Affairs Medical Center in Washington, D.C. The Department of Psychiatry at Georgetown University School of Medicine

VA Medical Center in Washington

Department of Veterans Affairs Central Office in Washington, D.C. The National Institute on Drug Abuse in Rockville, Maryland

1991 by the American Psychiatric Association

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Abstract

A retrospective audit of patients' utilization of inpatient psychiatric care at a Department of Veterans Affairs medical center before and after implementation of a prospective payment system compared patterns of utilization by chronic and nonchronic patients. It also examined changes over time in the size of the two groups, total number of bed days used, mean number of admissions, mean length of stay, and mean cumulative two-year length of stay. Four years after implementation of the prospective payment system, chronic patients constituted 3 percent of the patient population but used 15.2 percent of all bed days. Both chronic and nonchronic patients bad a similar decrease in mean length of stay over the period, but chronic patients' mean number of admissions rose by more than 7O percent. The mean cumulative two-year length of stay of chronic patients remained stable over the period while that of the nonchronic patients decreased by 33.2 percent.

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