Contrasting models for combined medical and psychiatric inpatient treatment

• Published in: The American journal of psychiatry Vol. 142; no. 9; p. 1085
• Main Authors: Fogel, B S, Stoudemire, A, Houpt, J L
• Format: Journal Article
• Language: English
• Published: United States 01.09.1985
• Subjects: Depressive Disorder - therapy; Diagnosis-Related Groups; Fees, Medical; Hospital Units - economics; Hospital Units - organization & administration; Hospitalization - economics; Humans; Internal Medicine; Length of Stay; Mental Disorders - therapy; Models, Theoretical; Psychiatric Department, Hospital - economics; Psychiatric Department, Hospital - organization & administration; Psychophysiologic Disorders - therapy; Psychotherapy - economics; Referral and Consultation; Reimbursement Mechanisms
• ISSN: 0002-953X
• DOI: 10.1176/ajp.142.9.1085

The authors contrast the clinical, administrative, and reimbursement aspects of two units offering combined medical and psychiatric inpatient treatment, one under medical auspices (the medical/psychiatric model), the other under psychiatric auspices (the psychiatric/medical model). The typical patient on both units suffered from depression with prominent somatic symptoms. The psychiatric/medical model was clinically advantageous because of its greater capacity for containing agitated, psychotic, and suicidal behavior and because of its potentially longer lengths of stay for refractory patients. Furthermore, the psychiatric/medical model offers more predictable payment for psychotherapy under fee-for-service insurance and is less likely to be adversely affected by the current prospective payment system based on diagnosis-related groups.