Cost-offset analysis of mental health intervention for crime victims in the primary care setting

Persistent Link:
http://hdl.handle.net/10150/282205
Title:
Cost-offset analysis of mental health intervention for crime victims in the primary care setting
Author:
Woodruff, Wanda Joy, 1956-
Issue Date:
1996
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Based on financial and billing records, the medical utilization behavior of 105 working adult women members of an employer-sponsored prepaid healthcare plan was examined prospectively over a five-year period. Utilization was evaluated 2.5 years pre- and 2.5 years post-crime for three groups of women: nonvictims (those women reporting no prior history of crime event), victims of noncontact crimes (theft, burglary, attempted crimes), and victims of contact crimes (assault, rape, and rape/assault). Results of interrupted time-series analysis indicated an abrupt, permanent (at least extended) impact for the crime event on use of physician services that was significant for both groups of crime victims (noncontact and contact crimes). The findings were similar across outpatient medical utilization indicators (frequency of visits and associated costs/charges). In terms of percent changes in levels of usage over time, contact crime victims increased physician visits 32-36% over baseline, noncontact crime victims increased 30-50% from baseline, and there was no change in the nonvictim comparison subjects. A second analysis was conducted to investigate the effects of mental health treatment on the use of outpatient medicine. Groups were classified into mental health users and nonusers as well as victims of crime (no crime, noncontact crime, contact crime). Results of interrupted time-series assessment on the effects of psychosocial stress by victimization on medical utilization indicated non-significant changes-over-time for victims of noncontact and contact crimes as well as nonvictim comparison subjects who utilized mental health services during the 5-year study frame. Mental health usage was defined as one or more visits to the Department of Psychiatry within the 5-year measurement time frame. A decline in outpatient utilization from preassault baseline to postassault by 12-17% was observed for victims of contact crimes who received mental health services. The results lended support the hypothesis that increased utilization followed the experience of stress by crime victimization and, that mental health had a buffering role in the moderation of increased utilization following a stressful event. The results suggested that healthcare policy should consider greater access to mental health services and that these services may be most effectively utilized when directed toward special populations of medical patients.
Type:
text; Dissertation-Reproduction (electronic)
Keywords:
Health Sciences, Mental Health.; Women's Studies.; Psychology, Clinical.
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Psychology
Degree Grantor:
University of Arizona
Advisor:
Sechrest, Lee B.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_US
dc.titleCost-offset analysis of mental health intervention for crime victims in the primary care settingen_US
dc.creatorWoodruff, Wanda Joy, 1956-en_US
dc.contributor.authorWoodruff, Wanda Joy, 1956-en_US
dc.date.issued1996en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractBased on financial and billing records, the medical utilization behavior of 105 working adult women members of an employer-sponsored prepaid healthcare plan was examined prospectively over a five-year period. Utilization was evaluated 2.5 years pre- and 2.5 years post-crime for three groups of women: nonvictims (those women reporting no prior history of crime event), victims of noncontact crimes (theft, burglary, attempted crimes), and victims of contact crimes (assault, rape, and rape/assault). Results of interrupted time-series analysis indicated an abrupt, permanent (at least extended) impact for the crime event on use of physician services that was significant for both groups of crime victims (noncontact and contact crimes). The findings were similar across outpatient medical utilization indicators (frequency of visits and associated costs/charges). In terms of percent changes in levels of usage over time, contact crime victims increased physician visits 32-36% over baseline, noncontact crime victims increased 30-50% from baseline, and there was no change in the nonvictim comparison subjects. A second analysis was conducted to investigate the effects of mental health treatment on the use of outpatient medicine. Groups were classified into mental health users and nonusers as well as victims of crime (no crime, noncontact crime, contact crime). Results of interrupted time-series assessment on the effects of psychosocial stress by victimization on medical utilization indicated non-significant changes-over-time for victims of noncontact and contact crimes as well as nonvictim comparison subjects who utilized mental health services during the 5-year study frame. Mental health usage was defined as one or more visits to the Department of Psychiatry within the 5-year measurement time frame. A decline in outpatient utilization from preassault baseline to postassault by 12-17% was observed for victims of contact crimes who received mental health services. The results lended support the hypothesis that increased utilization followed the experience of stress by crime victimization and, that mental health had a buffering role in the moderation of increased utilization following a stressful event. The results suggested that healthcare policy should consider greater access to mental health services and that these services may be most effectively utilized when directed toward special populations of medical patients.en_US
dc.typetexten_US
dc.typeDissertation-Reproduction (electronic)en_US
dc.subjectHealth Sciences, Mental Health.en_US
dc.subjectWomen's Studies.en_US
dc.subjectPsychology, Clinical.en_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplinePsychologyen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorSechrest, Lee B.en_US
dc.identifier.proquest9720574en_US
dc.identifier.bibrecord.b34504643en_US
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