Psychiatrist and nonphysician mental health provider staffing levels in health maintenance organizations
Psychiatrist and nonphysician mental health provider staffing levels in health maintenance organizations
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DOI：
10.1176/ajp.155.3.405
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发表时间：
1998-03-01
影响因子：
17.7
通讯作者：
Pincus, HA
中科院分区：
文献类型：
--
作者：
Dial, TH;Bergsten, C;Pincus, HA
目的：本研究试图确定工作人员和团体模式健康维护组织(HMOS)中相当于全职精神科医生与成员的比例以及非内科精神卫生专业人员与精神科医生的比例，并将精神科医生与成员的比例与先前估计的收费服务和管理式医疗环境中所需的精神科医生与人口的比例进行比较。方法。美国团体健康协会(现在的美国健康计划协会)收集了30名工作人员和团体模型保健组织的精神卫生人员、注册人数和其他特征的数据。作者评估了每10万名HMO成员中相当于全职精神病学家和非医生精神卫生专业人员的数量，以及全职相当于非医生精神卫生专业人员与精神病学家的比率。结果：在被调查的卫生管理组织中，每10万名成员中有相当于全职精神科医生和非内科精神卫生专业人员的总体平均人数分别为6.8人和22.9人，非内科专业人员与精神科医生的总体平均比率为4.5。每100,000名成员中精神科医生的总人数不到1980年研究生医学教育国家咨询委员会估计的一半，该委员会假设的是按服务收费的环境，但比其他研究假设的管理保健环境下的估计高出约40%至80%。结论：尽管管理式护理主导的执业环境可能不需要像收费环境那样高的精神科医生与人口的比率，但它很可能支持比以前研究表明的更多的精神科医生。
Objective: This study attempts to determine the ratio of full-time-equivalent psychiatrists to members and that of nonphysician mental health professionals to psychiatrists in staff and group model health maintenance organizations (HMOs), and to compare the psychiatrist-to-member ratio with previous estimates of the required psychiatrist-to-population ratios in fee-for-service and managed care environments. Method. The Group Health Association of America (now the American Association of Health Plans) collected data on mental health staffing, enrollments, and other characteristics for 30 staff and group model HMOs. The authors evaluated the number of full-time-equivalent psychiatrists and nonphysician mental health professionals per 100,000 HMO members, and the ratio of full-time-equivalent nonphysician mental health professionals to psychiatrists. Results: The overall mean number of full-time-equivalent psychiatrists and nonphysician mental health professionals per 100,000 members in the responding HMOs was 6.8 and 22.9, respectively, The overall mean ratio of nonphysician professionals to psychiatrists was 4.5. The overall number of psychiatrists per 100,000 members is less than half the requirement estimated by the Graduate Medical Education National Advisory Committee in 1980, which assumed a fee-for-service environment, but it is about 40% to 80% greater than that estimated by other studies under the assumption of a managed care environment. Conclusions: Although a practice environment dominated by managed care may not require as high a psychiatrist-to-population ratio as a predominantly fee-for-service environment, it may well support a greater number of psychiatrists than previous studies have suggested.