The evolving academic health center: challenges and opportunities for psychiatry.

Objective: Regardless of the outcome of current efforts at healthcare reform, the resources that academic health centers need-to provide care for increasingly complex patient populations, support clinical innovation, grow the clinical enterprise, and carry out their research and teaching missions-are in jeopardy. This article examines the value proposition for psychiatry.

Method: The authors describe areas where academic departments of psychiatry have opportunities to help shape the future of academic health centers in a rapidly-changing healthcare environment and share their experience in leadership roles in academic psychiatry and in consulting to academic health center leaders.

Can quality survive continued downward price pressures? Panel discussion.

The following is a transcript, edited for publication, of a remarkable presentation at the Behavioral Healthcare Quality and Accountability Summit in June 1997 held in Bloomington, Minnesota. The original session consisted of four talks, but since we were unable to obtain permission from one of the participants, J. Rock Johnson, J.

The impact of preadmission approval and continued stay review on hospital stay and outcome among children and adolescents.

Managed care has emerged as the centerpiece of the health care industry's efforts to control costs and ensure appropriate use of hospital services. This study assesses the impact of managed care by preadmission approval and/or continued stay review on length of psychiatric hospitalization and clinical outcome of children and adolescents. The sample included 277 cases hospitalized in nine psychiatric specialty hospitals in 1990.

Urinary MHPG and clinical symptoms in patients with unipolar depression.

The relationship between levels of urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) and symptom scores on the Hamilton Rating Scale for Depression was examined in 31 patients with unipolar depression. Patients with either low MHPG or high MHPG showed significant sleep disturbance in the form of early morning awakening. Patients with mid-range or high MHPG showed decreased work and activities.