Rethinking access to alcohol treatment.
Rethinking access to alcohol treatment.
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重新考虑酒精治疗的机会。
DOI：
10.1007/978-0-306-47193-3_7
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Schmidt,LA
中科院分区：
文献类型：
--
作者：
Weisner,C;Schmidt,LA
酒精治疗系统是不断变化的医疗保健组织，专业和融资流的巨大，混乱的世界的一部分。随着变化的展开，我们需要不断更新我们对人们如何获得治疗以及沿途沿着障碍的理解。医疗和卫生服务研究传统上将寻求治疗视为个人自愿过程。研究集中在个人对治疗是否有效的信念，获得帮助的家庭支持，以及个人特征在倾向于寻求帮助的人中的作用。在这样做的时候，研究往往忽略了关注个人的关系，发挥越来越重要的作用，在治疗进入组织和社会不断变化的意见，一个强大的医疗反应酒精问题的重要性。今天，大型组织保险公司，员工援助计划，医疗，刑事司法和福利系统，占主导地位的途径，酒精治疗。为酗酒问题寻求帮助通常涉及警察或法院，或工作场所或福利办公室的胁迫，以及来自家人和朋友的压力。酒精治疗系统与刑事司法和福利系统越来越接近，相互依存程度也越来越高，部分原因是监狱人满为患和福利改革等外部发展。在管理式医疗下，医生、保险公司和健康计划通过决定谁能得到治疗，谁不能得到治疗，发挥着新的关键把关作用。虽然这些变化开始于私人保险计划，但它们正在迅速蔓延到公共医疗补助计划。管理式医疗的推广承诺了成本控制和更好的服务整合，但显然，也会限制和阻碍个人获得饮酒问题帮助的能力，并会影响他或她获得何种类型的服务。
Alcohol treatment systems are part of a vast, chaotic world of changing health care organizations, professions, and financing streams. As the changes unfold, we need to continually update our understanding of how people get to treatment and of the barriers along the way. Medical and health services research has traditionally viewed treatment-seeking as an individual, voluntary process. Studies have focused on the individual’s beliefs about whether treatment works, family support for obtaining help, and the role of personal characteristics in predisposing people to seek help. In doing so, the research has often neglected to pay attention to the individual’s relationships to organizations that play increasingly important roles in treatment entry and to a society with ever-shifting views on the importance of a strong medical response to alcohol problems.Today, large organizations–insurance companies, employee assistance programs, the medical, criminal justice, and welfare systems–dominate pathways to alcohol treatment. Getting help for a drinking problem typically involves coercion by the police or courts, or the workplace or welfare office, as well as pressure from family and friends. Alcohol treatment systems have grown closer to, and more interdependent with, criminal justice and welfare systems, in part, due to exogenous developments such as prison overcrowding and welfare reform. Under managed care, physicians, insurance companies, and health plans play new critical gatekeeping roles by determining who does and does not get treatment. While these changes began in private insurance plans, they are spreading rapidly to public ones such as Medicaid. The spread of managed care promises cost containment and better integration of services, but clearly, can also limit and encumber the individual’s ability to get help for a drinking problem and can affect what type of services he or she
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DOI：
--
发表时间：
1980
期刊：
影响因子：
--
作者：
J. Wiseman
通讯作者：
J. Wiseman
事实上的美国精神和成瘾疾病服务系统。
影响因子：
--
作者：
D. Regier;W. Narrow;D. Rae;R. Manderscheid;B. Locke;F. Goodwin
通讯作者：
F. Goodwin
针对酗酒工人的治疗方案的随机试验。
DOI：
10.1056/nejm199109123251105
发表时间：
1991
期刊：
The New England journal of medicine
影响因子：
--
作者：
Walsh,DC;Hingson,RW;Merrigan,DM;Levenson,SM;Cupples,LA;Heeren,T;Coffman,GA;Becker,CA;Barker,TA;Hamilton,SK
通讯作者：
Hamilton,SK
雇主赞助的酒精中毒和药物滥用治疗保险。
DOI：
10.15288/jsa.1988.49.456
发表时间：
1988
期刊：
Journal of studies on alcohol
影响因子：
--
作者：
Morrisey,MA;Jensen,GA
通讯作者：
Jensen,GA
DOI：
--
发表时间：
1990
期刊：
影响因子：
--
作者：
Gerstein Dr;Harwood Hj
通讯作者：
Harwood Hj