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Journal of Aging and Health, Vol. 12, No. 4, 560-578 (2000)
DOI: 10.1177/089826430001200406

Use of Mental Health Services by Persons with a Mental Illness in Nursing Facilities

Initial Impacts of OBRA87

Dennis G. Shea, PhD

Department of Health Policy and Administration, The Pennsylvania State University

Patricia A. Russo, PhD, MSW, RN

Senior Research Associate, Medstat, Washington, D.C.

Michael A. Smyer, PhD

Graduate School of Arts and Sciences, Boston College

Objective:To identify mental health service use patterns in nursing facilities subsequent to nursing home reforms in the Omnibus Budget Reconciliation Act of 1987. Methods:The study involves a retrospective analysis of Medicare Part B claims for mental health care for persons in a nursing facility in 1992 (N = 692) using the Medicare Current Beneficiary Survey. Mental health service use was described and analyzed using logistic regression. Results:Only 26% of nursing facility residents and 36% of residents with a mental illness had a mental health visit in 1992. Logistic regression confirms analyses prior to 1987 showing older residents and those in rural areas remain less likely to receive mental health visits. Discussion:Claims data collected after the passage of The Nursing Home Reform Act (NHRA) of 1987 indicate continued low levels of mental health treatment in nursing homes.


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