Rural and Urban Differences in Access to Psychiatric Partial Hospitalization Programs
Psychiatric partial hospitalization programs (PHPs) allow patients to reside at home while receiving intensive and structured services, routine psychiatric evaluation, medication management, and individual and group counseling in outpatient settings during the day. Psychiatric PHP services are covered by Medicare and Medicaid and are more frequently offered by hospitals than community mental health centers. Although some evidence indicates that PHP service utilization has grown overall over the past two decades, little information exists about the availability of psychiatric PHPs in non-metropolitan (rural) as compared to metropolitan (urban) areas. Similarly, little information exists about the provision of psychiatric PHPs by Medicare-designated Critical Access Hospitals (CAHs), rural referral hospitals, and sole community hospitals serving rural clientele.
The overarching purpose of this project is to describe the availability of psychiatric PHPs amongst hospitals in metropolitan, micropolitan, and other non-metropolitan areas nationally. The project will also shed light on the hospital characteristics (e.g., bed size, health system affiliation, and CAH and other rural designation status) associated with the provision of psychiatric PHPs. We will also explore, depending on the availability of data, the associations between hospital financial indicators and the provision of psychiatric PHPs. The American Hospital Association Annual Survey of approximately 6,300 hospitals will be analyzed to address these questions. Because psychiatric PHP services are financed by Medicare and Medicaid, the project findings will have federal policy relevance for improving the accessibility of outpatient mental health services. We anticipate writing a policy brief and/or manuscript to disseminate our findings.