The setting of psychiatric care for Medicare recipients in general hospitals with specialty units

This study examined the patient and hospital characteristics associated wit h whether patients with psychiatric disorders were treated on the psychiatr ic unit or on medical wards after admission to general hospitals with psych iatric units. Medicare data for 169,798 beneficiaries who had psychiatric d isorders and were admitted to general hospitals with psychiatric units were used to estimate logistic regressions of the probability of treatment on t he unit. Results showed that beneficiaries who had more than one psychiatri c diagnosis (except for substance use disorders), state buy-in coverage suc h as Medicaid, or previous psychiatric hospitalizations or who had ever bee n eligible for Medicare through disability were more likely to be treated o n the unit. Those who were older, admitted through the emergency department , or had greater medical morbidity or primary diagnoses other than schizoph renia or bipolar or major affective disorders were less likely to he treate d on the unit.