A biobehavioral model for hospital psychiatry in an era of increasing regulation and cost containment.

Psychiatric hospitalization is increasingly a target of cost reduction by employers and third-party payers. The authors describe an evaluation of a biobehavioral model for the treatment of a mixed population of public- and private-sector patients in the psychiatric unit of a general hospital under conditions of severe regulation and cost containment. The program combined behavioral-education technology based on principles of social reinforcement with the traditional medical model in which the psychiatrist specified the patient's individual treatment within the general programmatic framework. Patient progress was monitored using standardized clinic rating scales, which showed that between 85 and 96 percent of the patients had improved significantly at discharge after an average stay of 12 days. Based on that and other findings, the authors believe that the new programmatic technology of biobehavioral psychiatry has the flexibility to ameliorate the adverse effects of increasing regulation and cost containment, even under demanding clinical conditions.