Psychiatric And Medical Rehabilitation Discharges Skyrocket at New York City Hospitals | Archived

United Hospital Fund Reports Dramatic Surge in Psychiatric and Rehabilitation Hospitalizations While Hospital Admissions for Other Services Continue t

Release Date: 07.24.1998
Contact: rdeluna@uhfnyc.org
Contact Phone: 212-494-0733

NEW YORK, NEW YORK, JULY 24, 1998 -- Psychiatric and medical rehabilitation discharges from New York City hospitals increased by 46.9 percent between 1993 and 1997 while total hospital discharges for all other medical services declined by 1.1 percent during the same period, according to Hospital Watch, a quarterly report on hospital utilization and financial performance issued today by the United Hospital Fund.

"As two of the few inpatient services that are still growing, psychiatry and medical rehabilitation have taken on more importance to the city's hospitals," said Sharon Salit, Fund senior health policy analyst, who noted that these two areas accounted for 16.8 percent of total patient hospital days in 1997, up from 13.1 percent in 1993.

According to Hospital Watch, a major factor contributing to the growth of psychiatric discharges, which account for 80 percent of the discharges studied, is the continued downsizing of state psychiatric hospitals. The patient census in state psychiatric hospitals declined in the past four years by 25 percent in New York City and by 40 percent statewide, which is significant since many city residents are hospitalized outside the city. These recent cutbacks were made after earlier reductions, which brought the census in state psychiatric hospitals down to 6,600 in 1997 from nearly 25,000 in 1980.

Among the other factors cited in Hospital Watch as contributing to the growth in psychiatric discharges at the city's hospitals was the state's creation of short-stay observation beds in psychiatric emergency rooms. This has enabled patients formerly treated in emergency rooms to be admitted for brief hospital stays.

Finally, the report cites the pressures of managed care as leading to shorter hospital stays for psychiatric patients, which may result in higher readmission rates.

"Although most severely mentally ill persons are not yet enrolled in managed care programs, New York State plans to mandate enrollment of these individuals under mandatory Medicaid managed care beginning in early 1999," Ms. Salit said. She noted that Medicaid now pays for half of the city's psychiatric discharges.

The July 1998 issue of Hospital Watch reports on trends in utilization, operations, and financial performance of hospitals in New York City through the first half of 1997. It is based on analysis of institutional cost reports filed by each New York City hospital and responses to surveys conducted by the United Hospital Fund and the New York State Department of Health.

The United Hospital Fund is a philanthropic and health services research organization addressing critical issues affecting hospitals and health care in New York City and the nation