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Objective. We examine whether ethnic differences in use of inpatient mental health services exist when the usually confounding effects of minority status and culture are minimized or controlled. Data Sources and Study Setting. Secondary analyses were conducted using a national insurance claims database for 1.2 million federal employees and their dependents insured by the Blue Cross/Blue Shield (BC/BS) Federal Employees Plan (FEP). Study Design. The Andersen-Newman model of health utilization was used to analyze predisposing, enabling, and need variables as predictors of inpatient mental health utilization during 1983. The study design was cross-sectional. Data Collection. The study database was made up of BC/BS insurance claims, Office of Personnel Management employee data, and Area Resource File data. Principal Findings. No significant differences were found among blacks, whites, and Hispanics in the probability of a psychiatric hospitalization or in the number of inpatient psychiatric days. Regression analyses revealed younger age and psychiatric treatment of other family members as significant predictors of a hospitalization; region of residence, younger age, hospital bed availability, and high option plan enrollment were significant predictors of the number of treatment days. Conclusions. Ethnic differences in use of inpatient mental health services were not significant in this generously insured population. Further research involving primary data collection among large and diverse samples of ethnic individuals is needed to fully examine the effects of cultural and socioeconomic differences on use of mental health services., Although the literature on ethnicity and mental health has expanded considerably over the past two decades, few studies have examined and compared the use of inpatient mental health services by [...]

The effectiveness of analytic Interpretation is conditioned by a number of factors within the patient. within the analyst, and within the analytic situation. I will focus on one of these factors, part of the technical activity of the analyst that I will call follow-up interpretation, one which omitted, or even slighted, sharply diminishes the effectiveness of interpretation.

Higher medical costs incurred by persons with mental disorders was assessed by comparing users and non-users of mental health services in their use of medical (non-mental health) services. Insurance claims data for 4.8 million persons enrolled in the Federal Employees Plan in 1978 were examined. Policy-related recommendations include the need for coordinated mental and physical health care in primary care settings. In particular, the physical health problems of patients in mental health settings should not be ignored as these may cause or exacerbate distress and reduce the effectiveness of mental health treatment.

Use of outpatient mental health services by dependent children younger than 18 years of age enrolled in the Blue Cross and Blue Shield Federal Employees Plan (FEP) is examined in 1978 and 1983 focusing on a cut in benefits and a shift from high- to low-option plan enrollment between those years. While use rates increased from 2.13 to 2.76 by 1983, the average number of visits decreased from 18.9 to 12.8. High-option plan use exceeded low-option plan use in both years—2.26 versus 0.81 in 1978 and 3.58 versus 1.93 in 1983. In addition to benefit plan, ethnicity, parent's education, type of provider, and type of treatment setting also significantly predicted amount of use. Despite the strong evidence of the effects of benefit coverage, it is likely that need exceeded use even in this insured population of children and adolescents. Implications of the findings are discussed in the context of recent dramatic changes in mental service delivery including privatization, managed care initiatives to cut costs, and growing pressures for national health insurance.