Costs and utilization of substance abuse care in a privately insured population under managed care.
Costs and utilization of substance abuse care in a privately insured population under managed care.
复制标题
管理式护理下私人参保人群药物滥用护理的成本和利用。
DOI：
10.1176/ps.49.12.1573
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Sturm,R
中科院分区：
文献类型：
--
作者：
Schoenbaum,M;Zhang,W;Sturm,R
目的检查私人、雇主赞助、管理的行为医疗保健计划下药物滥用和心理健康治疗的成本和利用模式。方法数据来自1995年93个行为医疗保健计划中提出的索赔，涵盖617，133名成员。确定了精神健康和药物滥用护理的使用率，以及保险公司和患者为这两种护理支付的费用。平均数是按计划成员和每一服务类型的使用者计算的。3%的计划成员使用任何药物滥用服务; 5.2%使用心理健康服务。然而，在药物滥用患者中，平均费用是精神健康患者平均费用的两倍多。对于药物滥用治疗，每位使用者每年的费用为2,188美元，而精神卫生保健使用者为979美元。药物滥用治疗和精神卫生保健的年人均费用分别为6.51美元和50.08美元。药物滥用治疗费用增加反映了住院治疗和强化门诊治疗的使用率增加。总体而言，药物滥用成本占行为健康护理保险费用的13%，4%的健康保险的成本overwhelm. CONCLUSIONSSSubstance滥用覆盖占行为健康保险的保险支付的一小部分，以及一个非常小的部分，为身体和行为的健康护理的保险支付。
OBJECTIVECost and utilization patterns of substance abuse and mental health treatment under private, employer-sponsored, managed behavioral health care plans were examined.METHODSData were from claims made in 1995 in 93 behavioral health care plans covering 617,133 members. Rates of use of mental health and substance abuse care were determined, as were payments by insurers and patients for the two types of care. Means were calculated per plan member and per user of either of these service types.RESULTSApproximately. 3 percent of plan members used any substance abuse services; 5.2 percent used mental health services. However, among substance abuse patients, average costs were more than twice as high as average costs for mental health patients. For substance abuse treatment, the annual cost per user was 2,188,comparedwith 979 for users of mental health care. Annual per-member costs were 6.51forsubstanceabusetreatmentand 50.08 for mental health care. Higher costs for substance abuse treatment reflected greater rates of use of both inpatient and intensive outpatient treatment. Overall, substance abuse costs represented 13 percent of insurance payments for behavioral health care and perhaps. 4 percent of the cost of health insurance overall.CONCLUSIONSSubstance abuse coverage accounts for a small fraction of insurance payments for behavioral health coverage and a very small fraction of insurance payments for both physical and behavioral health care.