Skip to main content
NCBI home page
Health Services Research logoLink to Health Services Research
. 1990 Jun;25(2):387–420.

Organizational determinants of efficiency and effectiveness in mental health partial care programs.

A P Schinnar 1, E Kamis-Gould 1, N Delucia 1, A B Rothbard 1
PMCID: PMC1065634  PMID: 2113046

Abstract

The use of partial care as a treatment modality for mentally ill patients, particularly the chronically mentally ill, has greatly increased. However, research into what constitutes a "good" program has been scant. This article reports on an evaluation study of staff productivity, cost efficiency, and service effectiveness of adult partial care programs carried out in New Jersey in fiscal year 1984/1985. Five program performance indexes are developed based on comparisons of multiple measures of resources, service activities, and client outcomes. These are used to test various hypotheses regarding the effect of organizational and fiscal variables on partial care program efficiency and effectiveness. The four issues explored are: auspices, organizational complexity, service mix, and fiscal control by the state. These were found to explain about half of the variance in program performance. In addition, partial care programs demonstrating midlevel performance with regard to productivity and efficiency were observed to be the most effective, implying a possible optimal level of efficiency at which effectiveness is maximized.

Full text

PDF
387

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Astrachan B. M., Flynn H. R., Geller J. D., Harvey H. H. Systems approach to day hospitalization. Arch Gen Psychiatry. 1970 Jun;22(6):550–559. doi: 10.1001/archpsyc.1970.01740300070009. [DOI] [PubMed] [Google Scholar]
  2. Austin N. K., Liberman R. P., King L. W., DeRisi W. J. A comparative evaluation of two day hospitals. Goal attainment scaling of behavior therapy vs. milieu therapy. J Nerv Ment Dis. 1976 Oct;163(4):253–262. doi: 10.1097/00005053-197610000-00004. [DOI] [PubMed] [Google Scholar]
  3. Beigel A., Feder S. L. Patterns of utilization in partial hospitalization. Am J Psychiatry. 1970 Mar;126(9):1267–1274. doi: 10.1176/ajp.126.9.1267. [DOI] [PubMed] [Google Scholar]
  4. Dickey B., Binner P. R., Leff S., Uyeda M. K., Schlesinger M. J., Gudeman J. E. Containing mental health treatment costs through program design: a Massachusetts study. Am J Public Health. 1989 Jul;79(7):863–867. doi: 10.2105/ajph.79.7.863. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Guy W., Gross M., Hogarty G. E., Dennis H. A controlled evaluation of day hospital effectiveness. Arch Gen Psychiatry. 1969 Mar;20(3):329–338. doi: 10.1001/archpsyc.1969.01740150073011. [DOI] [PubMed] [Google Scholar]
  6. Herz M. I., Endicott J., Spitzer R. L., Mesnikoff A. Day versus inpatient hospitalization: a controlled study. Am J Psychiatry. 1971 Apr;127(10):1371–1382. doi: 10.1176/ajp.127.10.1371. [DOI] [PubMed] [Google Scholar]
  7. Kamis-Gould E. The New Jersey performance management system: a state system and uses of simple measures. Eval Program Plann. 1987;10(3):249–255. doi: 10.1016/0149-7189(87)90036-x. [DOI] [PubMed] [Google Scholar]
  8. Klar H., Frances A., Clarkin J. Selection criteria for partial hospitalization. Hosp Community Psychiatry. 1982 Nov;33(11):929–933. doi: 10.1176/ps.33.11.929. [DOI] [PubMed] [Google Scholar]
  9. Lamb H. R. Chronic psychiatric patients in the day hospital. Arch Gen Psychiatry. 1967 Nov;17(5):615–621. doi: 10.1001/archpsyc.1967.01730290103013. [DOI] [PubMed] [Google Scholar]
  10. Linn M. W., Caffey E. M., Jr, Klett C. J., Hogarty G. E., Lamb H. R. Day treatment and psychotropic drugs in the aftercare of schizophrenic patients. A Veterans Administration cooperative study. Arch Gen Psychiatry. 1979 Sep;36(10):1055–1066. doi: 10.1001/archpsyc.1979.01780100025002. [DOI] [PubMed] [Google Scholar]
  11. Neffinger G. G. The evolution of an acute day treatment program. Hosp Community Psychiatry. 1980 Dec;31(12):826–828. doi: 10.1176/ps.31.12.826. [DOI] [PubMed] [Google Scholar]
  12. Nunamaker T. R. Measuring routine nursing service efficiency: a comparison of cost per patient day and data envelopment analysis models. Health Serv Res. 1983 Summer;18(2 Pt 1):183–208. [PMC free article] [PubMed] [Google Scholar]
  13. Reinhardt U. E. Manpower substitution and productivity in medical practice: review of research. Health Serv Res. 1973 Fall;8(3):200–227. [PMC free article] [PubMed] [Google Scholar]
  14. Schinnar A. P., Rothbard A. B., Hadley T. R. Opportunities and risks in Philadelphia's capitation financing of public psychiatric services. Community Ment Health J. 1989 Winter;25(4):255–266. doi: 10.1007/BF00755674. [DOI] [PubMed] [Google Scholar]
  15. Sherman H. D. Hospital efficiency measurement and evaluation. Empirical test of a new technique. Med Care. 1984 Oct;22(10):922–938. doi: 10.1097/00005650-198410000-00005. [DOI] [PubMed] [Google Scholar]
  16. Spitzer R. L., Fleiss J. L., Endicott J., Cohen J. Mental status schedule. Properties of factor-analytically derived scales. Arch Gen Psychiatry. 1967 Apr;16(4):479–493. doi: 10.1001/archpsyc.1967.01730220091013. [DOI] [PubMed] [Google Scholar]
  17. Weiss K. J., Dubin W. R. Partial hospitalization: state of the art. Hosp Community Psychiatry. 1982 Nov;33(11):923–928. doi: 10.1176/ps.33.11.923. [DOI] [PubMed] [Google Scholar]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust

RESOURCES