Am J Psychiatry 1980; 137:1065-1070
Copyright © 1980 by American Psychiatric Association
The Mental and Nervous Disorder Utilization and Cost Survey: an analysis of insurance for mental disorders
OB Towery, SS Sharfstein and ID Goldberg
The Mental and Nervous Disorder Utilization and Cost Survey in Washington,
D.C., has yielded useful information about outpatient utilization within an
insurance plan with broad mental health coverage, as well as evidence that
a comprehensive benefit with a low deductible and copayment can be offered
and reasonably utilized. From the results of this survey and a substudy of
claims made during 1977, the authors conclude that psychiatric diagnostic
information submitted on insurance claim forms may often be inaccurate,
primarily because of providers' concerns about confidentiality; such
information is of little use for peer review or claims review. The authors
state that caution must be exercised in generalizing from the experience
under this plan to speculate about outpatient utilization which might
result from broad coverage on a national level.
