BEFORE AND AFTER DEINSTITUTIONALIZATION - COMPARING STATE HOSPITALIZATION UTILIZATION, STAFFING, AND COSTS IN 1949 AND 1988

The literature on deinstitutionalization (DI) and state hospitals is c onsistent in several areas: patient census' at state facilities declin ed, staffing ratios increased, costs decreased with a net savings for state treasuries, and the number of state hospitals remained fairly co nstant or declined slightly. However, virtually all studies use data c ollected after DI had begun and span only a few years. This article re ports the results of data that spanned 39 years. Comparisons were made to examine the effects of DI on utilization, staffing, and costs (inf lation and population adjusted) at state hospitals. Newly opened hospi tals greatly outnumbered closed facilities over the time frame, thus t here were considerably more hospitals in 1988 than in 1949. The data a lso confirm that state hospitals have emerged from DI as different ins titutions with a new treatment emphasis reflected in shorter stays and professionalized staff. However, this comes at a greatly increased co st.