D D Mcalpine

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OBJECTIVES To describe models of integrated care used in the United States, assess how integration of mental health services into primary care settings or primary health care into specialty outpatient settings impacts patient outcomes and describe barriers to sustainable programs, use of health information technology (IT), and reimbursement structures of(More)
OBJECTIVE To examine the sociodemographic, need, risk, and insurance characteristics of persons with severe mental illness and the importance of these characteristics for predicting specialty mental health utilization among this group. DATA SOURCE The Healthcare for Communities survey, a national study that tracks alcohol, drug, and mental health services(More)
OBJECTIVE We sought to examine the extent to which reported barriers to health care services differ between American Indians (AIs) and non-Hispanic Whites (Whites). METHODS A statewide stratified random sample of Minnesota health care program enrollees was surveyed. Responses from AI and White adult enrollees (n=1281) and parents of child enrollees(More)
BACKGROUND Patient Outcomes Research Team treatment recommendations were used to investigate the relationship between patient characteristics and higher-than-recommended dosages (> 1000 chlorpromazine equivalents [CPZe]) at discharge. METHOD Inpatients who met the DSM-IV criteria for schizophrenia or schizoaffective disorder were recruited from 4 general(More)
BACKGROUND In this article we estimate the variations in receipt of age-appropriate preventive services among adult women between 21 and 64 years of age, by race and ethnic group, socioeconomic status, and access to health care. We also assess whether differences in access to care and socioeconomic status may explain racial and ethnic differences in the use(More)
Using data from the National Hospital Discharge Survey and the Inventory of Mental Health Organizations, this article examines national trends in psychiatric inpatient care from 1988 to 1994 in general hospitals and mental hospitals. We find that discharges with a primary diagnosis of mental illness in general hospitals increased from 1.4 to 1.9 million(More)
OBJECTIVE The study examined patterns of care for persons with mental illness in nursing homes in the United States from 1985 to 1995. During that period resident populations in public mental hospitals declined, and legislation aimed at diverting psychiatric patients from nursing homes was enacted. METHODS Estimates of the number of current residents with(More)
Care management-based interventions promoting integrated care by combining primary care with mental health services in a coordinated and colocated manner are increasingly popular; yet, the benefits of specific approaches are not well established. We conducted a systematic review of integrated care trials in US primary care settings to assess whether the(More)
In this paper, we examine sources of gender differences in depressive symptoms among adolescents. Using data collected from a self-administered survey of 306 high school students, we examine differences in the impact of life events, psychosocial resources, and parent-child relationships on levels of psychological distress. Our results confirm a substantial(More)
This paper examines the long-term impact of exposure to Medicaid in early childhood on adult health and economic status. The staggered timing of Medicaid's adoption across the states created meaningful variation in cumulative exposure to Medicaid for birth cohorts that are now in adulthood. Analyses of the Panel Study of Income Dynamics suggest exposure to(More)