|
| | |
|
Am J Psychiatry 1995; 152:869-875
Copyright © 1995 by American Psychiatric Association
Variation in ECT use in the United States
RC Hermann, RA Dorwart, CW Hoover and J Brody
Malcolm Wiener Center for Social Policy, John F. Kennedy School of Government, Harvard University, Cambridge, Mass., USA.
OBJECTIVE: The authors measured the variation in ECT utilization rates
across 317 metropolitan statistical areas of the United States and
determined to what degree this variation is associated with health care
system characteristics, demographic factors, and the stringency of state
regulation of ECT. METHOD: Data from APA's 1988-1989 Professional
Activities Survey were used to estimate ECT utilization rates for the
metropolitan statistical areas. Multiple regression analysis was used to
determine the relative influence of provider, demographic, and regulatory
factors on variation in ECT use across areas. RESULTS: Among the
psychiatrists surveyed, 17,729 reported treating 4,398 patients with ECT
during the study period. No ECT use was reported in 115 metropolitan
statistical areas. Among the remaining 202 metropolitan statistical areas,
annual ECT use varied from 0.4 to 81.2 patients per 10,000 population. The
strongest predictors of variation in ECT use across metropolitan
statistical areas were the number of psychiatrists, number of primary care
physicians, number of private hospital beds per capita, and stringency of
state regulation of ECT. CONCLUSIONS: Rates of ECT use were highly
variable, higher than for most medical and surgical procedures. In some
urban areas, access to ECT appears limited. Predictors of variation in ECT
rates have implications for expanding access to the procedure. The extent
of variation suggests psychiatrists continue to lack consensus regarding
the use of ECT. Better data on the effectiveness of psychiatric treatments
may lead to a broader professional consensus and may narrow variations in
clinical practices.
This article has been cited by other articles:
|
|
|
|
 
B. G. Druss, C. L. Miller, H. A. Pincus, and S. Shih
The Volume-Quality Relationship of Mental Health Care: Does Practice Make Perfect?
Am J Psychiatry,
December 1, 2004;
161(12):
2282 - 2286.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K.-F. Chung, Y. K. Ng, G. C. Yiu, and H. K. Cheung
Electroconvulsive therapy in Hong Kong
Psychiatr. Bull.,
March 1, 2003;
27(3):
102 - 104.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. V. ERANTI and D. M. McLOUGHLIN
Electroconvulsive therapy -- state of the art
The British Journal of Psychiatry,
January 2, 2003;
182(1):
8 - 9.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. C. Hermann, D. Yang, S. L. Ettner, S. C. Marcus, C. Yoon, and M. Abraham
Prescription of Antipsychotic Drugs by Office-Based Physicians in the United States, 1989-1997
Psychiatr Serv,
April 1, 2002;
53(4):
425 - 430.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. G. Kadar, B. A. Kramer, M. C. Barth, and P. F. White
Rapacuronium: An Alternative To Succinylcholine For Electroconvulsive Therapy
Anesth. Analg.,
May 1, 2001;
92(5):
1171 - 1172.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. L. Kramer, A. S. Daniels, G. L. Zieman, C. Williams, and N. A. Dewan
Psychiatric Practice Variations in the Diagnosis and Treatment of Major Depression
Psychiatr Serv,
March 1, 2000;
51(3):
336 - 340.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. C. Hermann, S. L. Ettner, R. A. Dorwart, N. Langman-Dorwart, and S. Kleinman
Diagnoses of Patients Treated With ECT: A Comparison of Evidence-Based Standards With Reported Use
Psychiatr Serv,
August 1, 1999;
50(8):
1059 - 1065.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
ECT and Managed Care
Journal Watch Psychiatry,
September 1, 1998;
1998(901):
19 - 19.
[Full Text]
|
|
|
|
|
|
|
R. C. Hermann, S. L. Ettner, R. A. Dorwart, C. W. Hoover, and E. Yeung
Characteristics of Psychiatrists Who Perform ECT
Am J Psychiatry,
July 1, 1998;
155(7):
889 - 894.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
J. Geddes, S. Reynolds, D. Streiner, P. Szatmari, and B. Haynes
Evidence-based practice in mental health
Evid. Based Ment. Health,
February 1, 1998;
1(1):
4 - 5.
[Full Text]
|
|
|
|
|
|
|
C. Salzman
ECT, Research, and Professional Ambivalence
Am J Psychiatry,
January 1, 1998;
155(1):
1 - 2.
[Full Text]
|
|
|
|
|
|
|
M. Olfson, S. Marcus, H. A. Sackeim, J. Thompson, and H. A. Pincus
Use of ECT for the Inpatient Treatment of Recurrent Major Depression
Am J Psychiatry,
January 1, 1998;
155(1):
22 - 29.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
J. Westphal, S. Kumar, J. Rush, and I. C. Sarkar
Addressing Issues of Face Validity in the Application of a Clinical Guideline
Eval Rev,
June 1, 1997;
21(3):
379 - 387.
[Abstract]
[PDF]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1995
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
