Benchmarking treatment of schizophrenia: a comparison of service delivery by the national government and by state and local providers.

This study compared treatment of schizophrenia in two types of organization: a national, government-operated health care system, the Department of Veterans Affairs (VA), and in hospitals and clinics operated by state and local providers. Between 1994 and 1996, 746 male patients with a clinical diagnosis of schizophrenia residing in two states in the Southeast and Midwest were surveyed: 192 VA inpatients were compared with 96 non-VA inpatients, and 274 VA outpatients were compared with 184 non-VA outpatients. VA patients were older and had higher incomes than non-VA patients but did not differ significantly on measures of clinical status, satisfaction with providers, or community adjustment.

Mental disorders and use of cardiovascular procedures after myocardial infarction.

Context: A number of studies have found race- and sex-based differences in rates of cardiovascular procedures in the United States. Similarly, mental disorders might be expected to be associated with lower rates of such procedures on the basis of clinical, socioeconomic, patient, and provider factors.

Objective: To assess whether having a comorbid mental disorder is associated with a lower likelihood of cardiac catheterization and/or revascularization after acute myocardial infarction.

Multiple outcome assessment in a study of the cost-effectiveness of clozapine in the treatment of refractory schizophrenia. Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia.

Objective: To develop new methods for combining results from multiple outcome domains and to demonstrate their application in a study of the cost-effectiveness of clozapine in treating hospitalized patients with refractory schizophrenia.

Data Sources/study Setting: Interview assessments, and administrative utilization and cost data, concerning 423 patients with refractory schizophrenia who had been hospitalized for 30-364 days during the year before study entry, at 15 VA medical centers.

Study Design: A 12-month double-blind trial compared clozapine (n = 205) and haloperidol (n = 218) in the treatment of refractory schizophrenia.

Effectiveness and cost of the inpatient treatment of posttraumatic stress disorder: comparison of three models of treatment.

Objective: This study compared the outcomes and costs of three models of Department of Veterans Affairs (VA) inpatient treatment for posttraumatic stress disorder (PTSD): 1) long-stay specialized inpatient PTSD units, 2) short-stay specialized evaluation and brief-treatment PTSD units, and 3) nonspecialized general psychiatric units.

Method: Data were drawn from 785 Vietnam veterans undergoing treatment at 10 programs across the country. The veterans were followed up at 4-month intervals for 1 year after discharge.

Race and outcome of treatment for veterans suffering from PTSD.

This study examines the relationship between racial group membership and psychometrically measured outcomes 4, 8 and 12 months after program entry in a program for veterans seeking treatment for war-related posttraumatic stress disorder (PTSD). Longitudinal assessment data were gathered and used to compare service use, clinicians' improvement ratings and psychometrically assessed clinical change among Black (n = 122) and White (n = 403) veterans treated at six geographically diverse sites. There were no significant differences between Blacks and Whites on any of the clinicians' improvement ratings, or on 13 of the 17 outcome measures.

Multisite experimental cost study of intensive psychiatric community care.

A 2-year experimental cost study of 10 Intensive Psychiatric Community Care (IPCC) programs was conducted at Department of Veterans Affairs (VA) medical centers in the Northeast. High hospital users were randomly assigned to either IPCC (n = 454) or standard VA care (n = 419) at four neuropsychiatric (NP) and six general medical and surgical (GMS) hospitals. National computerized data were used to track all VA health care service usage and costs for 2 years following program entry.

A short form of the Mississippi Scale for measuring change in combat-related PTSD.

In large-scale surveys or program evaluations, investigators most often wish to assess multiple domains of functioning, while at the same time minimizing the overall length of the data collection protocols. In addition, studies of treatment interventions require instruments which offer the greatest opportunity of detecting change in the variables of interest. Toward these ends, we present an 11-item version of the Mississippi Scale for Combat-Related PTSD.

Wartime military service and utilization of VA health care services.

This study sought to examine predisposing, enabling, and illness characteristics associated with use of Department of Veterans Affairs (VA) health care services. In view of VA's unique mission to care for war veterans, special attention was given to features of wartime military service as predisposing factors for VA health care use. Data from a 1987 national survey of veterans were used to compare VA users and non-users.