Psychiatric findings among child psychiatric inpatients grouped by public and private payment

OBJECTIVE: The study compared school-age psychiatric inpatients whose care was publicly funded with those whose care was privately funded to determine whether the public patients presented with more psychiatric risk factors and more psychiatric problems. METHODS: Retrospective chart review was used to collect data on the demographic and personal characteristics, behavior in the hospital, and response to milieu treatment of 40 public patients and 40 private patients. Half of each group were admitted during 1985-1986, and half during 1991-1993. Characteristics of the two groups were compared, and trends over time were examined. RESULTS: The public group presented for hospitalization with significantly more risk factors and psychiatric problems. Public status predicted the use of certain interventions, such as time-outs and physical holding. Public patients responded less positively to the treatment program. They had three times the number of bed-days as the private group during 1991-1993. CONCLUSIONS: Public patients require more intensive and extensive inpatient treatment and will be more profoundly affected by the restrictions on psychiatric inpatient care in the current climate of fiscal restraint.