Mental health/medical care cost offsets: opportunities for managed care.
(9/7951)
Health services researchers have long observed that outpatient mental health treatment sometimes leads to a reduction in unnecessary or excessive general medical care expenditures. Such reductions, or cost offsets, have been found following mental health treatment of distressed elderly medical inpatients, some patients as they develop major medical illnesses, primary care outpatients with multiple unexplained somatic complaints, and nonelderly adults with alcoholism. In this paper we argue that managed care has an opportunity to capture these medical care cost savings by training utilization managers to make mental health services more accessible to patients whose excessive use of medical care is related to psychological factors. For financial reasons, such policies are most likely to develop within health care plans that integrate the financing and management of mental health and medical/surgical benefits. (+info)
Drug problems dealt with by 62 London casualty departments. A preliminary report.
(10/7951)
A study of the whole spectrum of drug incidents dealt with in one month by 62 casualty departments in the Greater London area was carried out in the summer of 1975. Apart from demonstrating the large number of such incidents, this preliminary report presents an analysis of the drugs responsible for these episodes, basic demographic characteristics of the drug users, and an estimate of the contribution of drug dependence. (+info)
Harm reduction: Australia as a case study.
(11/7951)
This paper explicates the term, "harm reduction"; demonstrates that harm reduction has a long tradition; and uses one country, Australia, as a case study. Harm reduction can be understood as "policies and programs which are designed to reduce the adverse consequences of mood altering substances without necessarily reducing their consumption"; it is consistent with the best traditions of both medicine and public health. Although it is difficult to interpret trends in mortality from alcohol, tobacco, and illicit drugs to determine whether harm reduction in Australia "worked", the effectiveness of harm-reduction policies and programs in controlling HIV among injecting drug users (IDUs) seems extremely strong and suggests that benefits of harm-reduction programs for other drugs will become apparent in time. (+info)
Harm reduction in Bern: from outreach to heroin maintenance.
(12/7951)
In Switzerland, harm-reduction programs have the support of the national government and many localities, in congruence with much of the rest of Europe and in contrast with the United States, and take place in public settings. The threat of AIDS is recognized as the greater harm. This paper describes the overall national program and highlights the experience from one city; the program is noteworthy because it is aimed at gathering comparative data from controlled trials. (+info)
Psychosocial correlates of health compromising behaviors among adolescents.
(13/7951)
The objective of the present study was to examine psychosocial correlates of diverse health-compromising behaviors among adolescents of different ages. The study population included 123,132 adolescents in sixth, ninth and 12th grades. Psychosocial correlates of substance abuse, delinquency, suicide risk, sexual activity and unhealthy weight loss behaviors were examined. Risk-taking disposition was significantly associated with nearly every behavior across age and gender groups. Other consistent correlates included sexual abuse and family connectedness. Correlates of health-compromising behaviors tended to be consistent across age groups. However, stronger associations were noted between sexual abuse and substance use for younger adolescents, and risk-taking disposition and school achievement were stronger correlates for older youth. The results suggest the presence of both common and unique etiological factors for different health-compromising behaviors among youth. The results emphasize the importance of focusing on positive 'risk-taking' experiences for youth in prevention programs; being sensitive to possible sexual abuse experiences among both female and male adolescents in health-care consultations; integrating strategies for improved family connectedness into health promotion efforts; and making school relevant for all adolescents. (+info)
Infectious diseases and anemia in a sample of out-of-treatment drug users.
(14/7951)
OBJECTIVE: To understand how the prevalence of anemia, human immunodeficiency virus (HIV), and syphilis in a sample of out-of-treatment drug users affected delivery of care in a managed care model. STUDY DESIGN: A snowball sampling design with multiple zero order contacts was used in targeted census tracts with a high incidence of illicit drug use and sexually transmitted diseases. PATIENTS AND METHODS: Out-of-treatment drug users were recruited as part of a national multisite study of HIV risk behaviors in this population. Subjects were recruited using targeted community-based sampling. RESULTS: The rate of individuals who tested positive for both syphilis and HIV was 2.5 times greater than those who tested positive for syphilis only and 2.8 times greater than those who tested positive for HIV only. Of the men, 16.1% were anemic, and 33.3% of women were anemic. Rates of HIV (10.7%) and syphilis (19.8%) were found to be high among both male and female drug users. These statistics, coupled with the prevalence of anemia, indicate that drug users have many more problems other than drug use, a conclusion which can have an impact on how managed care plans approach drug users. CONCLUSION: A multipronged interdisciplinary approach may be warranted for both the patient and the managed care organization. (+info)
Child health statistics review, 1998.
(15/7951)
There is a broad spectrum of data that can be used to describe the health of young people in the UK. These data are of varying quality, reflecting in part the methods used to collect them. However, it is often frustrating trying to locate information relevant to young people: so many of the apparently obvious sources of data, such as routine surveillance data, are either not collated centrally, or are not related to a defined population. Perhaps, with the recently introduced changes in commissioning health services within England and Wales, local pressure will bring about an improvement in this. (+info)
Antidepressants are not drugs of abuse or dependence.
(16/7951)
There is a view among both the lay and medical audience that antidepressants are addictive. Non-compliance may arise as a result, with fatal consequences in some cases. In spite of the fact that anti-depressants have not proved to be drugs of abuse or dependence, confusion exists in the literature, particularly regarding the definition of the terms misuse and abuse in opioid addicts. Here, antidepressants are used to treat the depressive component of the addictive syndrome and have proved effective. In some instances, however, misuse of antidepressants has been found in methadone-treated addicts, which may be due to an enhancement of the effects of methadone. These effects have led some people to believe, wrongly, that antidepressants are substances of abuse. Our findings, from a review of the literature, show that such use of antidepressants by methadone patients is by definition misuse and not abuse. Further, the known withdrawal symptoms which occasionally follow cessation of anti-depressant therapy are not, on their own, an indication of addictive potential. We therefore conclude that antidepressant drugs are not substances of abuse and dependence. (+info)