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Item Health Outcomes and Cost of Care Among Older Adults with Schizophrenia: A 10-Year Study Using Medical Records across the Continuum of Care(Elsevier, 2014-05) Hendrie, Hugh C.; Tu, Wanzhu; Tabbey, Rebeka; Purnell, Christianna E.; Ambuehl, Roberta J.; Callahan, Christopher M.; Department of Psychiatry, IU School of MedicineObjectives The population of older patients with schizophrenia is increasing. This study describes health outcomes, utilization, and costs over 10 years in a sample of older patients with schizophrenia compared to older patients without schizophrenia. Design, Setting, Participants An observational cohort study of 31,588 older adults (mean age 70.44 years) receiving care from an urban public health system, including a community mental health center, during 1999–2008. 1635 (5.2%) were diagnosed with schizophrenia and 757 (2.4%) had this diagnosis confirmed in the community mental health center. Patients’ electronic medical records were merged with Medicare claims, Medicaid claims, the Minimum Dataset, and the Outcome and Assessment Information Set. Information on medication use was not available. Measurements Rates of comorbid conditions, health care utilization, costs, and mortality. Results Patients with schizophrenia had significantly higher rates of congestive heart failure (45.05% v. 38.84%), chronic obstructive pulmonary disease (52.71% v. 41.41%), and hypothyroidism (36.72% v. 26.73%) than the patients without schizophrenia (p<0.001). They had significantly lower rates of cancer (30.78% v. 43.18%) and significantly higher rates of dementia (64.46% v. 32.13%). The patients with schizophrenia had significantly higher mortality risk (HR: 1.25, CI: 1.07–1.47) than the patients without schizophrenia. They also had significantly higher rates of health care utilization. The mean costs for Medicare and Medicaid were significantly higher for the patients with schizophrenia than for the patients without schizophrenia. Conclusions The management of older adult patients with schizophrenia is creating a serious burden for our health care system, requiring the development of integrated models of health care.Item Mental health services research: moving from academia to the community(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2010-06) Callahan, Christopher M.; Hendrie, Hugh C.; Department of Medicine, IU School of MedicineItem Provider Expectations for Recovery Scale: Refining a measure of provider attitudes(2013) Salyers, Michelle P.; Brennan, Madeline; Kean, JacobItem A Statewide Collaboration to Initiate Mental Health Screening and Assess Services for Detained Youths in Indiana.(APHA, 2014-10) Aalsma, Matthew C.; Schwartz, Katherine; Perkins, Anthony J.; Department of Pediatrics, IU School of MedicineObjectives. We describe a statewide effort to implement detention-based mental health screening and assess follow-up services offered to detained youths in Indiana.Methods. A total of 25 265 detention stays (15 461 unique youths) occurred between January 1, 2008, and December 31, 2011, across 16 detention centers participating in the Indiana Juvenile Mental Health Screening Project. We collected screening results and reports of detention-based follow-up mental health services and referrals from justice system records.Results. Approximately 21% of youths screened positive for mental health issues requiring follow-up. A positive screen significantly predicted that youths would receive a follow-up mental health service or referral while detained or upon detention center discharge, compared with youths who did not screen positive (61% vs 39%). Logistic regression models indicated that a positive screen was associated with (1) contact with a mental health clinician within 24 hours of detention center intake and (2) a mental health referral upon discharge. White youths were more likely than minorities to receive both follow-up services.Conclusions. Future statewide efforts to improve the mental health of detained youths should incorporate standards for providing appropriate follow-up services in detention centers.