Health services research
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Health services research · Aug 1999
Randomized Controlled Trial Comparative Study Clinical TrialEffects of the Medicare Alzheimer's Disease Demonstration on caregiver burden and depression.
Does improved access to community-based care reduce perceived burden and reported levels of depression among primary caregivers of people with dementia? ⋯ Both the fact that these programmatic differences did not translate into substantial treatment group reductions in caregiver burden or depression, and the consistency of these findings with those of prior case management evaluations suggest the need to reformulate this programmatic intervention into areas not previously tested: 24-hour care, crisis intervention, coordination with primary care, or chronic disease management.
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Health services research · Aug 1999
Comparative StudyDifferences between generalists and mental health specialists in the psychiatric treatment of Medicare beneficiaries.
To examine differences between the general medical and mental health specialty sectors in the expenditure and treatment patterns of aged and disabled Medicare beneficiaries with a physician diagnosis of psychiatric disorder. ⋯ Mental health care provided to Medicare beneficiaries in the general medical sector does not appear to substitute perfectly for care provided in the specialty sector. Our study suggests that the treatment patterns in the specialty sector may be preferred by some patients; further, earlier findings indicate geographic barriers to obtaining specialty care. Thus, the matching of service use to clinical need among this vulnerable population may be inappropriate. The need for further research on outcomes is indicated.