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Mental Health Care in McAllen Texas: Utilization, Expenditure, and Continuum of Care

Irigoyen, Josefina
http://rave.ohiolink.edu/etdc/view?acc_num=antioch1398421681

Abstract Details

2014, Psy. D., Antioch University, Antioch New England: Clinical Psychology.
In 2009, Gawande published an article in The New Yorker that put the unknown mid-sized South Texas city of McAllen on the map. The article stated that McAllen was one of the most expensive health care markets in the country; it caused such media-frenzy that in a few days President Barack Obama (2009) began citing McAllen in his speeches for health care reform. Gawande concluded that overspending in the area was due to overutilization of medical services. The present study examined whether mental health services are overutilized based on archival data on McAllen's mental health services collected from Medicaid, Tropical Texas Behavioral Health (a McAllen area community mental health center [CMHC]), and The Behavioral Center at Doctors Hospital at Renaissance (a McAllen area private hospital). Findings yielded that diagnostic-related groups significantly impacted the average length of stay, as well as total costs for psychiatric inpatient treatment in McAllen, TX. Schizophrenia spectrum disorders required more days of treatment within the hospital than Bipolar disorders and further more days than Depressive disorders. Correspondingly, inpatient treatment of Schizophrenia spectrum disorders cost an additional $5,554.80 when compared to Bipolar disorders and $9,095.16 more than for Depressive disorders. Additionally, the readmission rate at Doctors Hospital was 26.72%, with nearly 1/4 of patients being readmitted at least once, and nearly 7% had 4 or more psychiatric hospitalizations within a one-year period. This readmission rate was higher than the national average perhaps because of inadequate after-care outpatient treatment in McAllen. Medicaid data showed that Texas consistently failed to contribute any state moneys to mental health spending; and that Massachusetts saw a considerably smaller increase in mental health expenditures over a 10-year period for both inpatient and outpatient services when compared to the United States as a whole (i.e., 26% vs. 260% for inpatient and 8% vs. 239% for outpatient, respectively). Furthermore, when compared to 2 reputable mental health care institutions (i.e., McLean Hospital and Brookline CMHC) in the Boston, Massachusetts area, McAllen''s continuum of care for mental health services fell short, with McAllen lacking considerably in step-down care and assessment.
Gargi Roysircar, Ph.D. (Committee Chair)
David Hamolsky, Psy.D. (Committee Member)
Carlotta Willis, Ph.D. (Committee Member)
101 p.
Clinical Psychology
mental health disparity; Texas mental health care; Latino mental health; medicaid mental health expenditures; psychiatric inpatient treatment; continuum of care

Recommended Citations

Citations

  • Irigoyen, J. (2014). Mental Health Care in McAllen Texas: Utilization, Expenditure, and Continuum of Care [Doctoral dissertation, Antioch University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1398421681

    APA Style (7th edition)

  • Irigoyen, Josefina. Mental Health Care in McAllen Texas: Utilization, Expenditure, and Continuum of Care . 2014. Antioch University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=antioch1398421681.

    MLA Style (8th edition)

  • Irigoyen, Josefina. "Mental Health Care in McAllen Texas: Utilization, Expenditure, and Continuum of Care ." Doctoral dissertation, Antioch University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1398421681

    Chicago Manual of Style (17th edition)

antioch1398421681
601
© 2014, all rights reserved.
This open access ETD is published by Antioch University and OhioLINK.