BACKGROUND: Anecdotal reports of the effects of managed care restrictions suggest anerosion of medical and nursing care. Yet, few substantive data are available to indicate that patients fare better or worse.
OBJECTIVES: To identify the characteristics of a large hospital's managed behavioralhealth population in relation to observed nursing care needs, level of patient functioning on admission and discharge, and length of stay.
STUDY DESIGN: A retrospective medical chart review was conducted on inpatients undermanaged behavioral health care contracts admitted and discharged between April 1995and January 1996.
RESULTS: On discharge, patients showed improvement on all behavioral subsystem ratings, with statistically significant differences in dependency, affiliative, aggressive- protective, achievement, and restorative subsystems. Patients with longer stays weresignificantly more impaired than patients with shorter stays on discharge Global Assessment of Functioning scores.
CONCLUSION: Expansion of the database to derive meaningful conclusions about theimpact of managed care on the resolution of nursing care problems is discussed. (JAm Psychiatr Nurses Assoc [1998]. 4, 57-66)
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