UPBEAT: the impact of a psychogeriatric intervention in VA medical centers. Unified Psychogeriatric Biopsychosocial Evaluation and Treatment

Medical Care
G KominskiW Van Stone

Abstract

The Unified Psychogeriatric Biopsychosocial Evaluation and Treatment (UPBEAT) program provides individualized interdisciplinary mental health treatment and care coordination to elderly veterans whose comorbid depression, anxiety, or alcohol abuse may result in overuse of inpatient services and underuse of outpatient services. To determine whether proactive screening of hospitalized patients can identify unrecognized comorbid psychiatric conditions and whether comprehensive assessment and psychogeriatric intervention can improve care while reducing inpatient use. Randomized trial. Veterans aged 60 and older hospitalized for nonpsychiatric medical or surgical treatment in 9 VA sites (UPBEAT, 814; usual care, 873). The Mental Health Inventory (MHI) anxiety and depression subscales, the Alcohol Use Disorder Identification Test (AUDIT) scores, RAND 36-Item Health Survey Short Form (SF-36), inpatient days and costs, ambulatory care clinic stops and costs, and mortality and readmission rates. Mental health and general health status scores improved equally from baseline to 12-month follow-up in both groups. UPBEAT increased outpatient costs by $1,171 (P <0.001) per patient, but lowered inpatient costs by $3,027 (P = 0.017), for an over...Continue Reading

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Citations

Nov 11, 2003·Critical Reviews in Oncology/hematology·Darryl Wieland
Nov 6, 2004·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Ritesh MistryUNKNOWN UPBEAT Collaborative Group
Mar 20, 2009·Annual Review of Public Health·Kenneth W Kizer, R Adams Dudley
Apr 6, 2013·Cost Effectiveness and Resource Allocation : C/E·K Melissa KeWilliam Hollingworth
Jan 1, 2010·ClinicoEconomics and Outcomes Research : CEOR·Jim E BantaAbdullah Sherzai
Jun 25, 2013·Journal of Interprofessional Care·Gillian NisbetStewart Dunn
Mar 7, 2012·Journal of Interprofessional Care·Esther SuterRuby Grymonpre
Apr 21, 2012·American Journal of Preventive Medicine·Verughese JacobUNKNOWN Community Preventive Services Task Force
Oct 15, 2010·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Alison M MudgeNancy A Pachana
Jul 19, 2017·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Pallavi DhamTarek K Rajji
Feb 7, 2003·International Journal of Geriatric Psychiatry·H LavretskyUNKNOWN UPBEAT Collaborative Group
Feb 18, 2010·Journal of Hypertension·Pietro Amedeo ModestiSaulo Sirigatti

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