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Girardet RG, Shellman AB, Llorens A, Nguyen L, Ellsworth M, Rennie K, Ha C. Evaluation of an Intensive Program for Children With Co-occurring Medical and Emotional Disorders. Clin Pediatr (Phila) 2022; 61:605-614. [PMID: 35677990 DOI: 10.1177/00099228221091429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study objective was to assess clinical outcomes and cost avoidance of an intensive day treatment program for children with co-occurring chronic medical disease and emotional problems. Intensive day treatment programs for this population are uncommon, and their effectiveness has not been previously reported. A total of 175 children were enrolled during the 3-year study period. Children had more than 30 medical diagnoses including chronic pain, dysautonomia, neurologic disorders, and diabetes. Complete utilization data were available for 118 patients, and demonstrated decreased hospitalizations and increased behavioral health visits during the 12 months post program compared with 12 months prior. Private insurance and female sex were associated with reduced utilization costs after program participation. Estimated avoided cost for the 118 children was $1 111 485. Patients reported significant improvements in somatic symptoms, sleep problems, inattention, depression, anger, and anxiety. Limited data indicated improvements in school attendance. Additional research addressing other outcomes, such as school-related symptoms, would be helpful.
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Affiliation(s)
- Rebecca G Girardet
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Pediatrics, The University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Alison B Shellman
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ashlie Llorens
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Anew Psychological Services, Houston, TX, USA
| | - Linh Nguyen
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Misti Ellsworth
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kimberly Rennie
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,NeuroBehavioral Health, Milwaukee, WI, USA
| | - Carolyn Ha
- Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Katy Psychological Services, Katy, TX, USA
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Psychiatric Partial Hospitalization Programs: Following World Health Organization Guidelines with a Special Focus on Women with Delusional Disorder. WOMEN 2021. [DOI: 10.3390/women1020008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The World Health Organization (WHO) developed a 7-year Mental Health Action Plan in 2013, which recommends integration of health and social care services into community-based settings, implementation of strategies for health promotion and prevention of illness, and support of research. In this review, we highlight partial hospitalization programs (PHPs) for delusional disorder (DD), with a special focus on the health and psychosocial needs of women. We suggest that PHPs are, in many ways, ideal settings for carrying out WHO recommendations. PHPs are multidisciplinary and consequently are able to provide a wide range of flexible program offerings. Programming in PHPs is able to address, with proven efficacy, individual needs, such as those presented by women at the various stages of their reproductive life. PHPs are a community bridge between hospital and outpatient services and can quickly adapt to specific needs as affected by gender, but also by age and cultural origins. They are ideal settings for professional training and for conducting clinical research. PHPs operate on the principle of shared decision making, and thus more readily than many other treatment sites, engaging difficult-to-treat patients, such as those with DD, by successfully establishing long-term relationships of trust.
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