Abstract
While estimates of the incidence and prevalence of mental disorder in the elderly vary, the consensus is that the need for services will remain unmet in the foreseeable future and geriatric mental health programs will continue to be seriously underfunded. Because of this, older people in general are treated in more restrictive and less appropriate settings than are younger mentally disturbed persons. The coming of DRGs and R UGs, the new prospective methods of health care reimbursement, are likely to compound this potentially lethal situation. It has been suggested that the implementation of these systems will produce an underfunding of psychiatric care that will create strong incentives to limit further both in- and outpatient mental health services to older people. The manner in which this may occur is the main focus of the article. Alternative models to acute care and DRGs for mental health care of the elderly, and their respective assets and liabilities, are also presented.
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