Ana Barbara Suarez - Academia.edu (original) (raw)

Papers by Ana Barbara Suarez

RAND Corporation eBooks, 2003

The MiUtary Health System 0/SHS) has approximately 8.7 million eligible beneficiaries. These bene... more The MiUtary Health System 0/SHS) has approximately 8.7 million eligible beneficiaries. These beneficiaries include active duty military personnel and their family members, retired military personnel and their family members, and surviving family members of deceased military persormel. In 2001, the Department of Defers (DoD) spent just over $2 billion on pharmacy benefits. Much like the private health care sector, the MIK has experienced a rapid growtii in pharmaceutical expenditures, which have increased an average of 17 percent a year over the past six years. Botii the DoD and Ae U.S. Congress have identified the MIB pharmacy benefit as an area for reform. To this end. Section 701 of the National Defense Autiiorization Act for Fiscal Year 2000 requires the Secretary of Defei^e to establish an effective, efficient, and integrated pharmacy benefite program. According to ttie legislation, titled the Pharmacy Benefits Redesign Program, "The pharmacy benefits program shall include a imiform formulary of pharmaceutical agents which shall assure the availability of pharmaceutical agente in the complete range of therapeutic classes...," The Act further specifies that "[t]he uniform formulary will be applicable to all prescribers within ttie facilities of the imiformed services (i.e., military treatment facilities [MTFs]) and the TRICARE program. The pharmaceutical agente on the formulary will be available through the MTFs and retail pharmacies designated or eligible imder the TRICARE program, as well as the National Mail Order Pharmacy program." Thus, imder the new pharmacy benefit program, tiie Secretary of Defense must submit to Congress the results of surveys of TRICARE prescribers (physicians, physician assistante, and nurse practitioners with prescribing privileges) who practice at MTFs or at TRICARE network facilities. The legislation specifically requires two confidential surveys on the imiform formulary, one conducted preimplementation and one conducted post-implementation. RAND's National Defense Research Mstitute was asked by the TRICARE Management Activity to design and conduct the prescriber survey mandated by the statute. The survey of clinicians was designed to assess how prescribers who work in MTFs or who are under the supervision of TRICARE contractor perceive formulary restrictiorw. The baseline survey discussed in this report attempte to gauge prescribers' perceptions of the formularies' impact on clinical decisions. IV aggregate cost, quality of care, and accessibility of health care provided to MHS beneficiaries. To inform future implementation and monitoring of the uniform formulary system, the study also seeks to gather information on prescribers' perceptions of the rationale behind formulary systems within the MHS. This report was prepared at the request of the study's sponsor to document the baseline survey effort and describe the survey findings. Basic univariate and some bivariate analyses are presented to highlight differences between the survey subsamples. The report's primary intended audience is the sponsoring office. However, this research should also interest defense health policymakers and those in pharmacy benefits management in both the private and public health care sectors.

El proyecto Sentidos es el resultado del convenio realizado entre la Universidad Industrial de Sa... more El proyecto Sentidos es el resultado del convenio realizado entre la Universidad Industrial de Santander, bajo el liderazgo de la Escuela de Trabajo Social, y el Instituto de la Juventud, el Deporte y la Recreacion de Bucaramanga. El proyecto tiene como finalidad fortalecer el desarrollo comunitario del barrio La Juventud integrando a sus diferentes actores sociales. Bajo el marco del proyecto SENTIDOS se realizo la investigacion de corte cuantitativo sobre sexualidad con los jovenes de los parches del barrio; el objetivo de la investigacion fue identificar el comportamiento, las actitudes, expectativas y necesidades sexuales que tiene este tipo de poblacion con el fin de formular una propuesta de intervencion con jovenes de los parches. Este proceso de intervencion fue orientado bajo los lineamientos de la Sociologia del Conocimiento la cual permite hacer un acercamiento a los conocimientos de la realidad que tienen los jovenes de los parches, para realizar una interpretacion de la misma y generar una forma de intervencion que permita transformarla y construirla desde la mirada de las personas que la estan viviendo. A partir de los resultados de la investigacion en donde se evidencia la desinformacion y los tabues sexuales que aun persisten en este tipo de poblacion y el manejo de la sexualidad como producto del medio y de la interaccion dentro de los parches, se diseno una propuesta de atencion integral en donde se busca apuntar hacia la inclusion social de los jovenes que solo puede ser posible mediante el acceso a la educacion, salud, empleo y participacion politica y cultural.

Medisan, Jul 1, 2013

desde noviembre de 2010 hasta abril de 2011, para determinar el estado actual de la formación epi... more desde noviembre de 2010 hasta abril de 2011, para determinar el estado actual de la formación epistemográfica de los tecnólogos de la salud. Se utilizaron métodos teóricos y empíricos, propios de la investigación pedagógica, los cuales revelaron insuficiencias en el conocimiento práctico y reflexivo de temáticas relacionadas con las tecnologías de la salud, limitaciones en la exactitud, claridad, concisión y originalidad de los textos, así como en su reflexión epistemológica. Se concluye que existen dificultades en cuanto a las estrategias de superación profesional del tecnólogo de la salud, que permitan la producción de textos científicos, por lo que se introducen nuevas propuestas para su tratamiento. Palabras claves: formación epistemográfica, textos científicos, divulgación científica, tecnología de la salud.

Estudos E Pesquisas Em Psicologia, Aug 1, 2011

This is the first in a series examining the changing characteristics practicing psychiatrists.

Industria Farmaceutica Equipos Procesos Y Tecnologia, 1990

Psychiatric Services, 2001

M ajor changes have occurred in the financing and organization of the mental health care system. ... more M ajor changes have occurred in the financing and organization of the mental health care system. These changes are particularly evident when trends in psychiatrists' professional activities and the settings of these activities are examined. This is the third and final column in a series focusing on changes in the practice of psychiatry as revealed in analyses of data from two large national surveys of psychiatrists, the 1988-1989 Professional Activities Survey (1) and the 1998 National Survey of Psychiatric Practice (2).

The National Defense Authorization Act for Fiscal Year (FY) 2000 established the authority for a ... more The National Defense Authorization Act for Fiscal Year (FY) 2000 established the authority for a demonstration program under which eligible beneficiaries were to be permitted to enroll in the Uniformed Services Family Health Plan (USFHP) at any time. We will refer to this policy as "continuous open enrollment." Congress directed that the Department of Defense (DoD) test the feasibility and advisability of providing continuous open enrollment for a two-year period at a minimum of two (out of seven) USFHP sites; submit a report to Congress by March 15, 2001, evaluating the benefits and costs of the program; and make a recommendation concerning whether to authorize continuous open enrollment at all USFHP sites on a permanent basis.

PsycEXTRA Dataset

Abstract : The military health system serves roughly 9 million eligible beneficiaries, including ... more Abstract : The military health system serves roughly 9 million eligible beneficiaries, including active duty military personnel and their family members, retired military personnel and their family members, and surviving family members of deceased military personnel. Eligible beneficiaries access health care services through the TRICARE program. Mental health care, as well as other forms of health care under TRICARE, is delivered through the direct care system, which consists of military-owned treatment facilities (clinics and hospitals), and the purchased-care system, which consists of coverage for care rendered in the civilian sector. TRICARE provides coverage for most medically necessary mental health care services, including those delivered in inpatient, outpatient, and partial hospitalization settings by qualified providers. In response to the National Defense Authorization Act (NDAA) for Fiscal Year 2001, the Department of Defense implemented a 1-year demonstration project designed to expand access to mental health services by easing TRICARE restrictions on services provided by licensed or certified mental health counselors (LMHCs). Currently, LMHCs must meet several eligibility and administrative requirements to serve as authorized TRICARE providers, including documentation of referral and supervision from a physician. Under the demonstration project, LMHCs who met the TRICARE eligibility requirements were allowed to provide services to covered beneficiaries without referral by physicians or adherence to supervisory requirements. In the NDAA, Congress requested an evaluation of the demonstration's impact on utilization, costs, and patient outcomes. This report describes the evaluation efforts by the RAND Corporation and presents findings based on several sources of data. The report is organized according to specific responses to the evaluation's objectives outlined in the FY01 NDAA and is intended to be included in the sponsor's final report to Congress.

American Journal of Psychiatry, 1998

, the proportion of psychiatrists 39 years old or younger has decreased and the proportion of tho... more , the proportion of psychiatrists 39 years old or younger has decreased and the proportion of those 55 years old or older has increased. In 1996, psychiatrists saw, on average, 35.4 unduplicated patients and worked an average of 46.4 hours in a typical week. Patients with mood disorders as their primary diagnoses accounted for the greatest proportion of psychiatrists' caseloads, followed by patients with anxiety disorders, then those with schizophrenia and other psychotic disorders. Public sources of payment and uncompensated care were the main sources of payment for psychiatrists services for 41.7% of patients. The primary payment mechanism for psychiatrists' patient care services was fee-for-service, accounting for 52.5% of psychiatrists' income from direct patient care. Twenty-nine percent of psychiatric patients received care through some form of managed care system, and 41.6% received treatment through a nonmanaged public or private health plan. Conclusions: As psychiatry moves into the next century, findings from the National Survey of Psychiatric Practice will form a baseline for monitoring changes and trends in the delivery and financing of mental health services.

Psychiatric Services, 1998

Psychiatric Services, 1999

Psychiatric Services, 1998

The Study of Outpatient Referral Patterns was conducted in 1998 to examine the nature of the comm... more The Study of Outpatient Referral Patterns was conducted in 1998 to examine the nature of the communication relationship between psychiatrists and primary care physicians regarding outpatient referrals. Nationally representative psychiatrists were surveyed (N 542) regarding their aggregate experience with outpatient referrals from non-psychiatric physicians in the previous 60 days. Data regarding frequency and type of information and mode of communication were gathered. Results indicate that primary care physicians represent a significant source of referrals to psychiatrists and that psychiatrists are generally satisfied with the communication interface with the referring physicians. Psychiatrists’ level of satisfaction was related to the quantity and quality of information provided by referring physicians. (Psychosomatics 2000; 41:245–252)

Psychiatric Services, 1998

This exploratory study examined utilization and costs among depressed patients in two treatment m... more This exploratory study examined utilization and costs among depressed patients in two treatment models-integrated treatment, in which psychotherapy and pharmacotherapy were provided by a psychiatrist, and split treatment, in which pharmacotherapy was provided by a psychiatrist and psychotherapy by a nonphysician psychotherapist. A quasi-experimental retrospective design was used to compare claims data from a national managed mental health care organization for 191 patients in integrated treatment and 1,326 in split treatment. During the 18-month study, patients receiving integrated treatment used significantly fewer outpatient sessions and had significantly lower treatment costs, on average, than those in split treatment. Integrated treatment appeared to be associated with a pattern of utilization characterized by frequent treatment episodes in contrast to that of split treatment, which was characterized by more sessions with fewer breaks of 90 days or more. The results do not support the prevailing assumption that integrated treatment is more costly than split treatment in a managed care network. Despite limitations in the study methods, the strength of these preliminary findings poses a powerful challenge and invites further study.

Estudos e Pesquisas em Psicologia, 2011

Del Prette y Almir Del Prette. Se concluye que la producción científica sobre Habilidades Sociale... more Del Prette y Almir Del Prette. Se concluye que la producción científica sobre Habilidades Sociales se realiza específicamente en torno a estudiantes y profesionales de la salud, así como también se concentra en el desarrollo de instrumentos fiables y válidos para la evaluación de las Habilidades Sociales. Se discuten los resultados identificando tendencias futuras de investigación. Palabras clave: Habilidades Sociales, Revisión bibliográfica, Argentina. RESUMO Partindo da tendência mundial de crescimento na produção de literatura na área das habilidades sociais, o presente artigo teve como objetivo realizar uma revisão bibliográfica da temática com o objetivo de descrever os trabalhos produzidos pelo Grupo de Pesquisa LACI (Laboratório de Comportamento Interpessoal), localizado em Córdoba, Argentina. O laboratório mencionado é um núcleo do Grupo de Relações Interpessoais e Habilidades Sociais (RIHS) da Universidade Federal de São Carlos, Brasil, dirigido pelos Doutores Zilda Del Prette e Almir Del Prette. Conclui-se que a produção científica sobre as habilidades sociais é feita especificamente em

Psychiatric Services, 2001

M ajor changes have occurred in the financing and organization of the mental health care system. ... more M ajor changes have occurred in the financing and organization of the mental health care system. These changes are particularly evident when trends in psychiatrists' professional activities and the settings of these activities are examined. This is the third and final column in a series focusing on changes in the practice of psychiatry as revealed in analyses of data from two large national surveys of psychiatrists, the 1988-1989 Professional Activities Survey (1) and the 1998 National Survey of Psychiatric Practice (2).

Medical Care, 2004

The objective of this study was to contrast experiences and opinion of providers in military trea... more The objective of this study was to contrast experiences and opinion of providers in military treatment facilities, where a single formulary is used, with those of community providers where multiple formularies and preferred lists are commonly encountered. Study Design: We conducted cross-sectional surveys. Setting: The study was conducted at military and community practices that serve military beneficiaries. Participants: We studied randomly selected clinicians, stratified by military treatment facility (MTF) size or number of military beneficiaries served. The final samples included 566 eligible MTF and 557 private clinicians, with 69% and 38% response rates, respectively. Outcome Measures: We wanted to determine experiences with and opinions of formularies and/or preferred lists and related policies. Results: Sixty-three percent of military providers were very familiar with formulary content and 60% with nonformulary request procedures; 67% thought their formulary was up-to-date and 84% felt Pharmacy & Therapeutics (P&T) committees were responsive to providers. In contrast, 23% of community providers felt very familiar with (multiple) formulary content and 10% with nonformulary request procedures. Only 15% perceived that formularies were current and 34% thought P&T committees were responsive to providers. Statistically significant differences remained after analysis of potential bias. Conclusions: Community providers were less aware and less satisfied with pharmacy benefits management policies than military providers, likely as a result of their daily interactions with multiple, unrelated pharmacy management systems. Addressing the problems expressed by community providers is imperative for pharmacy benefits managers.

Journal of the American Academy of Child & Adolescent Psychiatry, 1998

To capture information about the clinical characteristics of, and treatments for, children with a... more To capture information about the clinical characteristics of, and treatments for, children with attention-deficit/hyperactivity disorder (ADHD) in psychiatric practice. A mailed, self-administered questionnaire was sent to 81 practicing psychiatrists for them to complete on the next three consecutive patients aged 14 years and younger with ADHD seen during the 12-day study period. Information collected included the sociodemographic, clinical, and treatment characteristics of sampled patients. Patients in the study were predominantly white (85%), male (78%), and between 10 and 14 years old (58%). The most common ADHD subtype was combined/predominantly hyperactive (86%); 31% had no other comorbidity. Ninety-seven percent were receiving medications, with 49% receiving two or more. The single most common medication reported was methylphenidate (51% of patients) followed by clonidine (20%). Psychotropics other than psychostimulants were used in a majority of patients (55%). Psychiatrists, and child and adolescent psychiatrists in particular, see a more severely impaired and complex group of patients than would be expected of primary care providers. The treatment patterns of psychiatrists for these patients do not reflect the simpler treatments usually studied in clinical trials.

The Journal of Clinical Psychiatry, 2000

The goal of this study was to describe the sociodemographic and clinical characteristics and rout... more The goal of this study was to describe the sociodemographic and clinical characteristics and routine psychiatric care of depressed patients with or without substance use disorders (SUDs) and to assess the association between the presence of comorbid SUD and the psychiatric management of patients with depression. Each of a sample of 531 psychiatrists participating in the Practice Research Network (PRN) of the American Psychiatric Institute for Research and Education was asked to provide information about 3 randomly chosen patients. Data were collected using a self-administered questionnaire, which generated detailed diagnostic and clinical data on 1228 psychiatric patients. Weighted data were analyzed using the SUDAAN software package. Multivariate logistic regression was used to compare depressed patients with and without SUD. A total of 595 patients (48.4%) were diagnosed with depression (DSM-IV criteria). The prevalence of SUD (excluding nicotine dependence) in this group was 18.1%. The group with SUD had a significantly larger proportion of males, young adults, patients seen in public general hospitals, and non-managed care public plans. No significant group differences were found for primary payer, locus of care, length of treatment, type of current or past treatment, and prescription of medications. Only 2.2% of SUD patients were prescribed with an anti-SUD medication (i.e., disulfiram and naltrexone). Concomitant SUDs have little effect on the routine psychiatric care of depressed patients. Efforts should be made to improve the identification and management of depressed patients with SUD.

RAND Corporation eBooks, 2003

The MiUtary Health System 0/SHS) has approximately 8.7 million eligible beneficiaries. These bene... more The MiUtary Health System 0/SHS) has approximately 8.7 million eligible beneficiaries. These beneficiaries include active duty military personnel and their family members, retired military personnel and their family members, and surviving family members of deceased military persormel. In 2001, the Department of Defers (DoD) spent just over $2 billion on pharmacy benefits. Much like the private health care sector, the MIK has experienced a rapid growtii in pharmaceutical expenditures, which have increased an average of 17 percent a year over the past six years. Botii the DoD and Ae U.S. Congress have identified the MIB pharmacy benefit as an area for reform. To this end. Section 701 of the National Defense Autiiorization Act for Fiscal Year 2000 requires the Secretary of Defei^e to establish an effective, efficient, and integrated pharmacy benefite program. According to ttie legislation, titled the Pharmacy Benefits Redesign Program, "The pharmacy benefits program shall include a imiform formulary of pharmaceutical agents which shall assure the availability of pharmaceutical agente in the complete range of therapeutic classes...," The Act further specifies that "[t]he uniform formulary will be applicable to all prescribers within ttie facilities of the imiformed services (i.e., military treatment facilities [MTFs]) and the TRICARE program. The pharmaceutical agente on the formulary will be available through the MTFs and retail pharmacies designated or eligible imder the TRICARE program, as well as the National Mail Order Pharmacy program." Thus, imder the new pharmacy benefit program, tiie Secretary of Defense must submit to Congress the results of surveys of TRICARE prescribers (physicians, physician assistante, and nurse practitioners with prescribing privileges) who practice at MTFs or at TRICARE network facilities. The legislation specifically requires two confidential surveys on the imiform formulary, one conducted preimplementation and one conducted post-implementation. RAND's National Defense Research Mstitute was asked by the TRICARE Management Activity to design and conduct the prescriber survey mandated by the statute. The survey of clinicians was designed to assess how prescribers who work in MTFs or who are under the supervision of TRICARE contractor perceive formulary restrictiorw. The baseline survey discussed in this report attempte to gauge prescribers' perceptions of the formularies' impact on clinical decisions. IV aggregate cost, quality of care, and accessibility of health care provided to MHS beneficiaries. To inform future implementation and monitoring of the uniform formulary system, the study also seeks to gather information on prescribers' perceptions of the rationale behind formulary systems within the MHS. This report was prepared at the request of the study's sponsor to document the baseline survey effort and describe the survey findings. Basic univariate and some bivariate analyses are presented to highlight differences between the survey subsamples. The report's primary intended audience is the sponsoring office. However, this research should also interest defense health policymakers and those in pharmacy benefits management in both the private and public health care sectors.

El proyecto Sentidos es el resultado del convenio realizado entre la Universidad Industrial de Sa... more El proyecto Sentidos es el resultado del convenio realizado entre la Universidad Industrial de Santander, bajo el liderazgo de la Escuela de Trabajo Social, y el Instituto de la Juventud, el Deporte y la Recreacion de Bucaramanga. El proyecto tiene como finalidad fortalecer el desarrollo comunitario del barrio La Juventud integrando a sus diferentes actores sociales. Bajo el marco del proyecto SENTIDOS se realizo la investigacion de corte cuantitativo sobre sexualidad con los jovenes de los parches del barrio; el objetivo de la investigacion fue identificar el comportamiento, las actitudes, expectativas y necesidades sexuales que tiene este tipo de poblacion con el fin de formular una propuesta de intervencion con jovenes de los parches. Este proceso de intervencion fue orientado bajo los lineamientos de la Sociologia del Conocimiento la cual permite hacer un acercamiento a los conocimientos de la realidad que tienen los jovenes de los parches, para realizar una interpretacion de la misma y generar una forma de intervencion que permita transformarla y construirla desde la mirada de las personas que la estan viviendo. A partir de los resultados de la investigacion en donde se evidencia la desinformacion y los tabues sexuales que aun persisten en este tipo de poblacion y el manejo de la sexualidad como producto del medio y de la interaccion dentro de los parches, se diseno una propuesta de atencion integral en donde se busca apuntar hacia la inclusion social de los jovenes que solo puede ser posible mediante el acceso a la educacion, salud, empleo y participacion politica y cultural.

Medisan, Jul 1, 2013

desde noviembre de 2010 hasta abril de 2011, para determinar el estado actual de la formación epi... more desde noviembre de 2010 hasta abril de 2011, para determinar el estado actual de la formación epistemográfica de los tecnólogos de la salud. Se utilizaron métodos teóricos y empíricos, propios de la investigación pedagógica, los cuales revelaron insuficiencias en el conocimiento práctico y reflexivo de temáticas relacionadas con las tecnologías de la salud, limitaciones en la exactitud, claridad, concisión y originalidad de los textos, así como en su reflexión epistemológica. Se concluye que existen dificultades en cuanto a las estrategias de superación profesional del tecnólogo de la salud, que permitan la producción de textos científicos, por lo que se introducen nuevas propuestas para su tratamiento. Palabras claves: formación epistemográfica, textos científicos, divulgación científica, tecnología de la salud.

Estudos E Pesquisas Em Psicologia, Aug 1, 2011

This is the first in a series examining the changing characteristics practicing psychiatrists.

Industria Farmaceutica Equipos Procesos Y Tecnologia, 1990

Psychiatric Services, 2001

M ajor changes have occurred in the financing and organization of the mental health care system. ... more M ajor changes have occurred in the financing and organization of the mental health care system. These changes are particularly evident when trends in psychiatrists' professional activities and the settings of these activities are examined. This is the third and final column in a series focusing on changes in the practice of psychiatry as revealed in analyses of data from two large national surveys of psychiatrists, the 1988-1989 Professional Activities Survey (1) and the 1998 National Survey of Psychiatric Practice (2).

The National Defense Authorization Act for Fiscal Year (FY) 2000 established the authority for a ... more The National Defense Authorization Act for Fiscal Year (FY) 2000 established the authority for a demonstration program under which eligible beneficiaries were to be permitted to enroll in the Uniformed Services Family Health Plan (USFHP) at any time. We will refer to this policy as "continuous open enrollment." Congress directed that the Department of Defense (DoD) test the feasibility and advisability of providing continuous open enrollment for a two-year period at a minimum of two (out of seven) USFHP sites; submit a report to Congress by March 15, 2001, evaluating the benefits and costs of the program; and make a recommendation concerning whether to authorize continuous open enrollment at all USFHP sites on a permanent basis.

PsycEXTRA Dataset

Abstract : The military health system serves roughly 9 million eligible beneficiaries, including ... more Abstract : The military health system serves roughly 9 million eligible beneficiaries, including active duty military personnel and their family members, retired military personnel and their family members, and surviving family members of deceased military personnel. Eligible beneficiaries access health care services through the TRICARE program. Mental health care, as well as other forms of health care under TRICARE, is delivered through the direct care system, which consists of military-owned treatment facilities (clinics and hospitals), and the purchased-care system, which consists of coverage for care rendered in the civilian sector. TRICARE provides coverage for most medically necessary mental health care services, including those delivered in inpatient, outpatient, and partial hospitalization settings by qualified providers. In response to the National Defense Authorization Act (NDAA) for Fiscal Year 2001, the Department of Defense implemented a 1-year demonstration project designed to expand access to mental health services by easing TRICARE restrictions on services provided by licensed or certified mental health counselors (LMHCs). Currently, LMHCs must meet several eligibility and administrative requirements to serve as authorized TRICARE providers, including documentation of referral and supervision from a physician. Under the demonstration project, LMHCs who met the TRICARE eligibility requirements were allowed to provide services to covered beneficiaries without referral by physicians or adherence to supervisory requirements. In the NDAA, Congress requested an evaluation of the demonstration's impact on utilization, costs, and patient outcomes. This report describes the evaluation efforts by the RAND Corporation and presents findings based on several sources of data. The report is organized according to specific responses to the evaluation's objectives outlined in the FY01 NDAA and is intended to be included in the sponsor's final report to Congress.

American Journal of Psychiatry, 1998

, the proportion of psychiatrists 39 years old or younger has decreased and the proportion of tho... more , the proportion of psychiatrists 39 years old or younger has decreased and the proportion of those 55 years old or older has increased. In 1996, psychiatrists saw, on average, 35.4 unduplicated patients and worked an average of 46.4 hours in a typical week. Patients with mood disorders as their primary diagnoses accounted for the greatest proportion of psychiatrists' caseloads, followed by patients with anxiety disorders, then those with schizophrenia and other psychotic disorders. Public sources of payment and uncompensated care were the main sources of payment for psychiatrists services for 41.7% of patients. The primary payment mechanism for psychiatrists' patient care services was fee-for-service, accounting for 52.5% of psychiatrists' income from direct patient care. Twenty-nine percent of psychiatric patients received care through some form of managed care system, and 41.6% received treatment through a nonmanaged public or private health plan. Conclusions: As psychiatry moves into the next century, findings from the National Survey of Psychiatric Practice will form a baseline for monitoring changes and trends in the delivery and financing of mental health services.

Psychiatric Services, 1998

Psychiatric Services, 1999

Psychiatric Services, 1998

The Study of Outpatient Referral Patterns was conducted in 1998 to examine the nature of the comm... more The Study of Outpatient Referral Patterns was conducted in 1998 to examine the nature of the communication relationship between psychiatrists and primary care physicians regarding outpatient referrals. Nationally representative psychiatrists were surveyed (N 542) regarding their aggregate experience with outpatient referrals from non-psychiatric physicians in the previous 60 days. Data regarding frequency and type of information and mode of communication were gathered. Results indicate that primary care physicians represent a significant source of referrals to psychiatrists and that psychiatrists are generally satisfied with the communication interface with the referring physicians. Psychiatrists’ level of satisfaction was related to the quantity and quality of information provided by referring physicians. (Psychosomatics 2000; 41:245–252)

Psychiatric Services, 1998

This exploratory study examined utilization and costs among depressed patients in two treatment m... more This exploratory study examined utilization and costs among depressed patients in two treatment models-integrated treatment, in which psychotherapy and pharmacotherapy were provided by a psychiatrist, and split treatment, in which pharmacotherapy was provided by a psychiatrist and psychotherapy by a nonphysician psychotherapist. A quasi-experimental retrospective design was used to compare claims data from a national managed mental health care organization for 191 patients in integrated treatment and 1,326 in split treatment. During the 18-month study, patients receiving integrated treatment used significantly fewer outpatient sessions and had significantly lower treatment costs, on average, than those in split treatment. Integrated treatment appeared to be associated with a pattern of utilization characterized by frequent treatment episodes in contrast to that of split treatment, which was characterized by more sessions with fewer breaks of 90 days or more. The results do not support the prevailing assumption that integrated treatment is more costly than split treatment in a managed care network. Despite limitations in the study methods, the strength of these preliminary findings poses a powerful challenge and invites further study.

Estudos e Pesquisas em Psicologia, 2011

Del Prette y Almir Del Prette. Se concluye que la producción científica sobre Habilidades Sociale... more Del Prette y Almir Del Prette. Se concluye que la producción científica sobre Habilidades Sociales se realiza específicamente en torno a estudiantes y profesionales de la salud, así como también se concentra en el desarrollo de instrumentos fiables y válidos para la evaluación de las Habilidades Sociales. Se discuten los resultados identificando tendencias futuras de investigación. Palabras clave: Habilidades Sociales, Revisión bibliográfica, Argentina. RESUMO Partindo da tendência mundial de crescimento na produção de literatura na área das habilidades sociais, o presente artigo teve como objetivo realizar uma revisão bibliográfica da temática com o objetivo de descrever os trabalhos produzidos pelo Grupo de Pesquisa LACI (Laboratório de Comportamento Interpessoal), localizado em Córdoba, Argentina. O laboratório mencionado é um núcleo do Grupo de Relações Interpessoais e Habilidades Sociais (RIHS) da Universidade Federal de São Carlos, Brasil, dirigido pelos Doutores Zilda Del Prette e Almir Del Prette. Conclui-se que a produção científica sobre as habilidades sociais é feita especificamente em

Psychiatric Services, 2001

M ajor changes have occurred in the financing and organization of the mental health care system. ... more M ajor changes have occurred in the financing and organization of the mental health care system. These changes are particularly evident when trends in psychiatrists' professional activities and the settings of these activities are examined. This is the third and final column in a series focusing on changes in the practice of psychiatry as revealed in analyses of data from two large national surveys of psychiatrists, the 1988-1989 Professional Activities Survey (1) and the 1998 National Survey of Psychiatric Practice (2).

Medical Care, 2004

The objective of this study was to contrast experiences and opinion of providers in military trea... more The objective of this study was to contrast experiences and opinion of providers in military treatment facilities, where a single formulary is used, with those of community providers where multiple formularies and preferred lists are commonly encountered. Study Design: We conducted cross-sectional surveys. Setting: The study was conducted at military and community practices that serve military beneficiaries. Participants: We studied randomly selected clinicians, stratified by military treatment facility (MTF) size or number of military beneficiaries served. The final samples included 566 eligible MTF and 557 private clinicians, with 69% and 38% response rates, respectively. Outcome Measures: We wanted to determine experiences with and opinions of formularies and/or preferred lists and related policies. Results: Sixty-three percent of military providers were very familiar with formulary content and 60% with nonformulary request procedures; 67% thought their formulary was up-to-date and 84% felt Pharmacy & Therapeutics (P&T) committees were responsive to providers. In contrast, 23% of community providers felt very familiar with (multiple) formulary content and 10% with nonformulary request procedures. Only 15% perceived that formularies were current and 34% thought P&T committees were responsive to providers. Statistically significant differences remained after analysis of potential bias. Conclusions: Community providers were less aware and less satisfied with pharmacy benefits management policies than military providers, likely as a result of their daily interactions with multiple, unrelated pharmacy management systems. Addressing the problems expressed by community providers is imperative for pharmacy benefits managers.

Journal of the American Academy of Child & Adolescent Psychiatry, 1998

To capture information about the clinical characteristics of, and treatments for, children with a... more To capture information about the clinical characteristics of, and treatments for, children with attention-deficit/hyperactivity disorder (ADHD) in psychiatric practice. A mailed, self-administered questionnaire was sent to 81 practicing psychiatrists for them to complete on the next three consecutive patients aged 14 years and younger with ADHD seen during the 12-day study period. Information collected included the sociodemographic, clinical, and treatment characteristics of sampled patients. Patients in the study were predominantly white (85%), male (78%), and between 10 and 14 years old (58%). The most common ADHD subtype was combined/predominantly hyperactive (86%); 31% had no other comorbidity. Ninety-seven percent were receiving medications, with 49% receiving two or more. The single most common medication reported was methylphenidate (51% of patients) followed by clonidine (20%). Psychotropics other than psychostimulants were used in a majority of patients (55%). Psychiatrists, and child and adolescent psychiatrists in particular, see a more severely impaired and complex group of patients than would be expected of primary care providers. The treatment patterns of psychiatrists for these patients do not reflect the simpler treatments usually studied in clinical trials.

The Journal of Clinical Psychiatry, 2000

The goal of this study was to describe the sociodemographic and clinical characteristics and rout... more The goal of this study was to describe the sociodemographic and clinical characteristics and routine psychiatric care of depressed patients with or without substance use disorders (SUDs) and to assess the association between the presence of comorbid SUD and the psychiatric management of patients with depression. Each of a sample of 531 psychiatrists participating in the Practice Research Network (PRN) of the American Psychiatric Institute for Research and Education was asked to provide information about 3 randomly chosen patients. Data were collected using a self-administered questionnaire, which generated detailed diagnostic and clinical data on 1228 psychiatric patients. Weighted data were analyzed using the SUDAAN software package. Multivariate logistic regression was used to compare depressed patients with and without SUD. A total of 595 patients (48.4%) were diagnosed with depression (DSM-IV criteria). The prevalence of SUD (excluding nicotine dependence) in this group was 18.1%. The group with SUD had a significantly larger proportion of males, young adults, patients seen in public general hospitals, and non-managed care public plans. No significant group differences were found for primary payer, locus of care, length of treatment, type of current or past treatment, and prescription of medications. Only 2.2% of SUD patients were prescribed with an anti-SUD medication (i.e., disulfiram and naltrexone). Concomitant SUDs have little effect on the routine psychiatric care of depressed patients. Efforts should be made to improve the identification and management of depressed patients with SUD.