Objective: The authors evaluated the evolution of inpatient care for psychiatric illness in 1992 and 2002 for senior community-dwelling Medicare beneficiaries.
Methods: National Medicare Provider Analysis and Review files for 1992 and 2002 were analyzed.
Results: From 1992 to 2002, rates of inpatient hospital use for treatment of psychiatric illness declined 28%, from 429 to 311 stays per 100,000 eligible beneficiaries, mostly because of reduced hospitalization for depression, and next, for substance use disorder. Inpatient care patterns for patients with schizophrenia and bipolar disorder changed little. Although stays were shorter in 2002 in general, rehospitalization rates remained the same in 2002 as they were in 1992.
Conclusion: Trends in hospitalizations differed by diagnoses, which may be representative of general changes in treatment philosophy during the 1990s.