Predicting level of care in mental health services under a continuum of care

Abstract

In an effort to control the spiraling costs of mental health care, public and private sectors have moved rapidly toward managed mental health care. An important feature of many managed mental health care systems is the use of alternative or “intermediate” services in place of costly residential services. The introduction of these intermediate services affords clinicians a wider range of treatment options. Little is known, however, about the decision making process in assigning children to these services. Using data on an innovative system that made those services available, this article identifies predictors of intermediate service use. Multivariate analyses are based on different variants of logistic regression; the analysis illustrates the use of multinominal and nested logistic regression.