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Article   |    
A "Facilitated" Model of Inpatient Psychiatric Care
Kevin W. Olden; Michael P. Johnson
Psychiatric Services 1993; doi:
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The authors thank Patricia Flanagan, R. N., Jane Monahan, B. A., Sylvia Horn, M. P. H., and Dianne Zarcone, M. A., for reviewing and commenting on the manuscript. They also thank the medical records departments of Sequoia Hospital and the Kaiser Foundation Hospital in Redwood City for invaluable assistance in data collection.

Sequoia Hospital, Whipple and the Alameda, Redwood City, California 94062

Kaiser Foundation Health Plan in Redwood City

1993 by the American Psychiatric Association

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Abstract

The authors describe a model for an effective partnership between a large health maintenance organization and a fee-for service acute inpatient psychiatric unit. They present data from five years of experience with the model on a unit serving a catchment area of one million plan members. The model, which is based on "facilitated" care rather than managed care, emphasizes crisis intervention and a strong medical orientation. The HMO contracted with seven psychiatrists to provide treatment and helped develop a value system shared by the physicians and hospital staff A clinician represented the HMO on the unit and played a key decision-making role in patient care. A total of 4,945 patients were admitted over five years. Costs per admission were reduced 47 percent during this period; the readmission rate was 1 6.9 percent. implementation of the model resuited in the delivery of high-quality cost-effective care.

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