Claudia Hoover - Academia.edu (original) (raw)

Papers by Claudia Hoover

American Journal of Psychiatry, Jul 1, 1998

American Journal of Public Health, Aug 1, 1994

PubMed, Feb 1, 1991

Background: The delivery system for psychiatric inpatient services in the United States has chang... more Background: The delivery system for psychiatric inpatient services in the United States has changed dramatically over the past 30 years, undergoing a marked privatization. Method: To assess the effect of changes in ownership and types of inpatient settings on the structure of the mental health services system, the authors surveyed a national sample of nonfederal mental health facilities in 1988. Results: Comparing their data to those of earlier surveys, they found that a decline in the number of patients per staff occurred in most settings over the last decade, suggesting that this aspect of quality of care may have improved. They observed important ownership-related differences in 1988 in diagnostic mix (e.g., more schizophrenia treated in public facilities than in private ones) and in payer source (e.g., more third-party revenues in public facilities than occurred in the past). Conclusions: There was a significant interaction between ownership form and type of facility, suggesting that the type of inpatient setting, ownership, and the relation between the two should be considered in assessing the impact of privatization on the accessibility of health care available for the mentally ill. The authors found that the increase in private psychiatric hospitals has widened the availability and choice of treatment facilities for those with private funding sources (especially children and adolescents) but has not had a similar effect in increasing sources of care for the seriously mentally ill dependent upon public financing.

Academic Psychiatry, 1999

Because funding for teaching hospitals is threatened in the cost-conscious era of managed care, t... more Because funding for teaching hospitals is threatened in the cost-conscious era of managed care, teaching hospitals must demonstrate their value. To examine the clinical and community-service activities of teaching hospitals, this study compared academic medical centers (AMCs) and other hospitals operating psychiatric residency programs with nonteaching hospitals. Data for the study are from the National Mental Health Facilities Survey, a national survey of providers of inpatient psychiatric care in the United States conducted at the beginning of the current managed care era. When compared with nonteaching hospitals, both types of teaching hospitals offered a larger number of specialized services and had a higher psychiatrist-to-patient ratio. The AMCs received a higher proportion of their revenues from Medicaid than did the nonteaching hospitals. Other teaching hospitals collected a lower percentage of their inpatient charges than the nonteaching hospitals. This study supports the notion that psychiatric teaching hospitals provided more care to low-income and underinsured persons than the nonteaching hospitals and that they offer more services and more psychiatric oversight. The authors find justification for supporting psychiatric teaching hospitals for their clinical and community-service activities.

American Journal of Psychiatry, 1998

Consciousness and Self-Regulation, 1986

When we are upset or confused about an event, it often helps to write or to talk about it with so... more When we are upset or confused about an event, it often helps to write or to talk about it with someone. The mere act of organizing and categorizing the event makes us feel better and allows us to devote our attention to other things. Certain events, such as getting a parking ticket or having an airline lose our bags, can be assimilated and explained relatively easily. Others, however, such as being assaulted or being rejected by one’s spouse, require far more cognitive work in order to organize, understand, and ultimately to forget. One problem that occasionally occurs is that we are sometimes unable to discuss certain personally traumatic events for fear of embarrassment or punishment. In such cases, we must actively inhibit the confiding process. As will be seen, the inhibition process is itself stressful. Hence, the combined physiological effects of experiencing the trauma, attempting to assimilate the trauma, and inhibition can sum to produce long-term stress and susceptibility to disease. The model that we propose has evolved from rather diverse literatures and serendipitous observations. Because our research in this area is in a nascent stage, our model should be viewed as a tentative conceptual framework that will undoubtedly be revised over the next few years.

Health services research, 1997

To examine the prevalence and determinants of economically motivated transfers (aka "dumping... more To examine the prevalence and determinants of economically motivated transfers (aka "dumping") from hospitals treating mental illness. A composite data set constructed from three national random-sampled surveys conducted in 1988 and 1989: (1) of hospitals providing mental health care, (2) of community mental health centers, and (3) of psychiatrists. The study uses reports from administrators of community mental health centers (CMHCs) to assess the extent of patient dumping by hospitals. To assess the determinants of dumping, reported perceptions of dumping are regressed on variables describing the catchment area in terms of the proportion of for-profit hospitals, intensity of competition among hospitals, extent of utilization review, and capacity of the local treatment system, as well as competition among community mental health centers. To assess if dumping is motivated by factors distinct from those affecting other aspects of access, comparable regressions are estimated ...

Medical Care, 1997

This article examines the impact of increasing competition among hospitals on access to inpatient... more This article examines the impact of increasing competition among hospitals on access to inpatient services and preexisting differences in access between nonprofit and for-profit facilities. It tests theoretical propositions that suggest that nonprofit and for-profit hospitals will respond in different ways and to differing degrees to changing competitive pressures. Drawing data from a 1987-88 national survey of psychiatric hospitals, the authors measured access in terms of the availability of different types of services and the provision of uncompensated care. The impact of hospital ownership, competition as well as the interaction of ownership and competition was assessed through a set of regression models, controlling for other characteristics of the hospital markets and local service system. Nonprofit psychiatric hospitals provide greater access than their for-profit counterparts under conditions of limited competition. Increased competition reduces the ownership-related differences in uncompensated care, but increases the differences for marginally profitable services. The market share of for-profit hospitals had an independent negative effect on access, holding constant the intensity of competition. The interaction of ownership and competition explains some seemingly inconsistent finding in the literature and points to the complexity of relying on ownership-based policies to protect access in an increasingly competitive health-care system.

Journal of Personality and Social Psychology, 1987

Do people know what kinds of impressions they convey to other people during particular social int... more Do people know what kinds of impressions they convey to other people during particular social interactions? In a study designed to answer this question, subjects interacted individually with three partners on each of four different tasks. After each interaction, participants reported their impressions of the other person's likability and competence. They also postdicted the impressions they believed they conveyed to the other person along the same dimensions. Accuracy was computed as recommended by Cronbach (1955) and by Kenny's (1981) Social Relations Model. Subjects could tell to a significant degree how the impressions they conveyed to their partners changed over time (time accuracy) and how they changed over time in different ways with different partners (differential accuracy). They could also tell how their competence was differentially perceived by different partners (dyadic accuracy). However, they were not very accurate at discerning which partners perceived them as most competent or most likable across all interactions (person accuracy). Subjects believed that they conveyed similar impressions of themselves to all of their partners, although actually partners evidenced little agreement with each other in their impressions of a given subject. The implications of these findings for symbolic-interactionist theories of the development of the self and impression-management perspectives on social behavior are described.

Journal of Experimental Social Psychology, 1983

People encounter situations from different forms of awareness; that is. they can attend to differ... more People encounter situations from different forms of awareness; that is. they can attend to different focal topics (e.g., self, other person, or other person's situation) from different perspectives (e.g.. the self's viewpoint, the other person's viewpoint). Two studies assessed whether brief interactions would produce different forms of social awareness, whether the form of awareness would persist to a subsequent interaction, and whether it would influence helping in that encounter. Pedestrians on a city sidewalk were induced to become self-focused (experimenter took their picture), become other-focused (they took experimenter's picture), or empathically adopt the perspective of another person (they advised experimenter where to take a picture). In Study 1. subjects were interviewed after leaving the experimenter. First-and third-person pronoun use and self-ratings suggested that subjects had different forms of awareness. In Study 2, pedestrians participated in one of the same three interaction conditions or a control noninteraction condition and subsequently encountered a confederate in need of help. Subjects in the self-focused and empathic condition helped more than subjects in the otherfocused or control condition. Results suggest that forms of awareness created in a brief interaction do persist to subsequent interactions and influence helping. Other variables may influence helping by altering forms of social awareness.

Diabetes Care, 1985

Type I (insulin-dependent) diabetic individuals and health professionals often assume that the sy... more Type I (insulin-dependent) diabetic individuals and health professionals often assume that the symptoms of extremely low or high blood glucose (BG) levels can be recognized and, consequently, appropriate treatment decisions can be based on symptom perception. Because no research has documented the validity of these assumptions, this study tested the ability to perceive BG concentration. Nineteen type I adults, experienced in self-monitoring of BG (SMBG), estimated their BG 40–54 times just before measurement of actual BG. This procedure was repeated under two conditions: (1) in the hospital (hospital condition) while connected to an insulin/glucose infusion system that artificially manipulated BG, leaving subjects only symptomatic, or internal, cues and (2) in the natural environment (home condition), where both internal and external cues, e.g., food and insulin consumption, were available. Estimates significantly correlated with actual BG for 7 of 16 subjects in the hospital condit...

Biofeedback and Self-Regulation, 1984

American Journal of Public Health, 1994

OBJECTIVES. Shifts in care for the seriously mentally ill from inpatient to community-based treat... more OBJECTIVES. Shifts in care for the seriously mentally ill from inpatient to community-based treatment have highlighted the importance of transitional care. Our objectives were to document the kinds and quantity of transitional services provided by psychiatric hospitals nationally and to assess the impact of hospital type (psychiatric vs general), ownership (public vs private), case mix, and revenue source on provision of these services. METHODS. A national sample of nonfederal inpatient mental health facilities (n = 915) was surveyed in 1988, and data were analyzed by using multiple regression. RESULTS. Half (46%) of the facilities surveyed provided patient follow-up of 1 week or less, and almost all (93%) conducted team review of discharge plans, but 74% provided no case management services. Hospital type was the most consistent predictor of transitional care, with psychiatric hospitals providing more of these services than general hospitals. Severity of illness, level of nonfedera...

Child Development, 1989

DEPAULO, BELLA M.; TANG, JOHN; WEBB, WILLIAM; HOOVER, CLAUDIA; MARSH, KERRY; and LITowlTZ, CAROL.... more DEPAULO, BELLA M.; TANG, JOHN; WEBB, WILLIAM; HOOVER, CLAUDIA; MARSH, KERRY; and LITowlTZ, CAROL. Age Differences in Reactions to Help in a Peer Tutoring Context. CHILD DEVEL-OPMENT, 1989, 60, 423-439. Second and fourth graders (8-and ...