Am J Psychiatry 1985; 142:1085-1089
Copyright © 1985 by American Psychiatric Association
Contrasting models for combined medical and psychiatric inpatient treatment
BS Fogel, A Stoudemire and JL Houpt
The authors contrast the clinical, administrative, and reimbursement
aspects of two units offering combined medical and psychiatric inpatient
treatment, one under medical auspices (the medical/psychiatric model), the
other under psychiatric auspices (the psychiatric/medical model). The
typical patient on both units suffered from depression with prominent
somatic symptoms. The psychiatric/medical model was clinically advantageous
because of its greater capacity for containing agitated, psychotic, and
suicidal behavior and because of its potentially longer lengths of stay for
refractory patients. Furthermore, the psychiatric/medical model offers more
predictable payment for psychotherapy under fee-for-service insurance and
is less likely to be adversely affected by the current prospective payment
system based on diagnosis-related groups.
