D L Leslie

..Concerns over rising health care costs have led to pressure on health care providers to reduce inpatient costs...

..To examine the health care expenditures associated with autism spectrum disorders (ASDs) in medical care settings...

..The objective of this study is to estimate the fraction of a year of life lost associated with delirium at 1-year follow-up...

..This study investigated how antipsychotic pharmacotherapy and health care costs change after diabetes mellitus is newly diagnosed among patients with schizophrenia...

..To determine whether costs of long-term nursing home (NH) care for patients who received a multicomponent targeted intervention (MTI) to prevent delirium while hospitalized were less than for those who did not receive the intervention...

..When patients were dosed outside of the recommendations, patients treated at facilities with more emphasis on mental health and research and education were more likely to be dosed above the recommendations...

..The purpose of the study was to determine the proportion of patients with schizophrenia with a stable regimen of antipsychotic monotherapy who developed diabetes or were hospitalized for ketoacidosis...

..This study used measures of the quality of pharmacotherapy for patients with schizophrenia and compared these measures across a sample of patients from the Department of Veterans Affairs (VA) and the private sector...

..Although the substantial differences in the populations treated could account for the differences in these measures across systems, this study is useful in illustrating the possibilities and limitations of system comparisons...

..Concern over rising health care costs has put pressure on providers to reduce costs, purportedly by reducing inpatient care and increasing outpatient care...

..This paper presents a profile of the use of antipsychotic medications in the treatment of schizophrenia in a national health system...

..It demonstrated methods for measuring quality of mental health care and, using these measures, compared patients from Department of Veterans Affairs (VA) hospitals with privately insured patients...

..Institutional fiscal pressure does not seem to reduce the broad availability of these medications overall but does affect which drug is prescribed...

..Quetiapine was the least prescribed of the newer drugs. These results suggest that it is important that all of these medications are included in formularies...

..CONCLUSIONS: Changes in mental health service delivery have resulted in substantially reduced access to mental health care among children and significant declines in service use and costs among those who do receive services...

..To determine whether specific subsets of symptoms from the Geriatric Depression Scale (GDS), assessed at hospital admission, were associated with the incidence of delirium...

..Second-generation antipsychotics (SGAs) are prescribed for psychosis, aggression, and agitation in Alzheimer disease (AD)...

..High expenditures on these medications are thus likely to continue without concomitant gains for public health...

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..Although researchers have documented a decline in antidepressant use among children over this period, less is known about whether specific safety information conveyed in individual warnings was reflected in treatment patterns...

..Second-generation antipsychotics have largely replaced first-generation antipsychotics for the treatment of schizophrenia, but a large-scale cost/effectiveness analysis has not been attempted...

..To compare 1-year institutionalization and mortality rates of patients who were delirious at discharge, patients whose delirium resolved by discharge, and patients who were never delirious in the hospital...

..We determined whether state level variation in the cost of radical prostatectomy exists and whether we could explain this variation by adjusting for covariates associated with cost...

..Off-label prescribing of medications, polypharmacy, and other questionable prescribing practices have led investigators to examine a large VA pharmacy database to determine if physician prescribing decisions appear reasonable...

..This study lends support to recent concerns that the prevalence of bipolar disorder among the youth is increasing. Further research is needed to identify the underlying reasons for these observed changes...

..This study was designed to investigate the proportion of undiagnosed impaired fasting glucose and diabetes mellitus in patients prescribed clozapine at 8 Department of Veterans Affairs (VA) medical centers...

..To validate a chart-based method for identification of delirium and compare it with direct interviewer assessment using the Confusion Assessment Method (CAM)...

..This study used administrative data from a large national sample of patients with a diagnosis of schizophrenia to compare the prevalence of diabetes mellitus in patients receiving prescriptions for atypical and typical neuroleptics...

..This study compared measures of the quality of pharmacotherapy for patients with major depression across a sample of patients from the Department of Veterans Affairs (VA) and the private sector...

..The algorithm outlined here and the process for its implementation are intended as a stimulus for discussion of potential policy responses, not as a finalized proposition...

..While delirium has been increasingly recognized as a serious and potentially preventable condition, its long-term implications are not well understood. This study determined the total 1-year health care costs associated with delirium...

..01) or quetiapine (HR = 0.50; p < 0.10), while diabetes risk among females did not differ significantly from first-generation antipsychotics for any atypical examined. These findings are substantially different from other reports...

..However, the clinical significance of these data is, as yet, unclear. Although, in theory, adverse outcomes may have been associated with this practice, we could not confirm this with this database analysis...