ABSTRACT
Few data exist describing Medicaid's success in providing health care services to people with disabilities. The access to care survey from the Medical Expenditures Panel Survey was used to collect access data from 502 individuals with disabilities in central Missouri receiving Medicaid under fee-for-service reimbursement. Nearly all of the respondents had a usual source of care, but two-thirds reported difficulties obtaining a needed health care service. Dental, optometric, and personal assistance services were most difficult to obtain. Provider non-participation, non-coverage of a service, and coverage restrictions were the most frequently cited barriers to obtaining care. Results suggest that people with disabilities have difficulty accessing needed health care services through the Missouri Medicaid fee-for-service system.
Subject(s)
Disabled Persons , Health Services Accessibility/statistics & numerical data , Medicaid/economics , Adult , Disabled Persons/statistics & numerical data , Fee-for-Service Plans , Female , Health Services Accessibility/economics , Humans , Male , Medicaid/statistics & numerical data , Missouri , United StatesABSTRACT
Two-year stability coefficients were computed for several measures of borderline personality disorder within a nonclinical sample (n = 65) that included individuals with significant borderline features. Overall, the stability coefficients were modest (r ranging from .28 to .62; intraclass correlations ranging from .26 to .62). Stability values for each of the self-report measures under study were higher than those for the interview-based measure of BPD features, and, in some cases, these values varied as a function of the prototypicality of the subsamples examined. Analyses conducted to identify moderator effects provided no evidence that the stability of BPD scores was moderated by change in personal distress level; however, changes in BPD self-report scores were related to changes in level of negative affectivity.
Subject(s)
Borderline Personality Disorder/diagnosis , Adult , Borderline Personality Disorder/psychology , Disease Progression , Female , Humans , Male , Prospective Studies , Psychological Tests , Self-Assessment , Severity of Illness Index , Time FactorsABSTRACT
Borderline personality disorder (BPD) is thought to develop by early adulthood, and it is characterized by lack of control of anger, intense and frequent mood changes, impulsive acts, disturbed interpersonal relationships, and life-threatening behaviors. We describe data from a 2-year follow-up study of nonclinical young adults who, at study entry, exhibited a significant number of BPD features. Individuals with borderline features were more likely to have academic difficulties over the succeeding 2 years, and these participants were more likely to meet lifetime criteria for a mood disorder and to experience interpersonal dysfunction than their peers at the 2-year follow-up assessment. These findings indicate that BPD features are associated with poorer outcome even within a nonclinical population.