Mental health expenditures for services for people with severe mental illnesses.
Mental health expenditures for services for people with severe mental illnesses.
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用于为患有严重精神疾病的人提供服务的精神卫生支出。
DOI：
10.1176/ps.48.4.485
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Sweeney,JK
中科院分区：
文献类型：
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作者：
Hollingsworth,EJ;Sweeney,JK
ObjectiveObjectives为大量患有严重精神疾病的人提供心理健康和药物滥用服务支出的全面信息，本研究探讨了使用主要类型的临床医疗心理健康和精神病康复服务在一年period.MethodsData获得了1,890名客户在10个公共县为基础的非大都市的精神卫生系统在威斯康星州。支出用于公共资金提供的服务，包括当地资金来源、医疗补助和医疗保险。有关服务和支出的数据来自1989年和1990年12个月的县记录和无重复的医疗补助索赔。结果每位客户一年的平均支出为10，995美元（按1994年美元计算为13，992美元），最高为95，093美元。社区门诊服务支出，包括住宿护理和职业服务，占所有支出的53.5%;住宿护理占12.4%，职业服务占5.7%。总体而言，46.5%用于机构护理，住院护理占12.6%。大约40.6%的总支出是服务通常不包括在管理式医疗plannes.ConclusionsExpenditures为基础的社区医疗占总支出的一半以上。支出模式表明，社会和康复服务发挥着重要作用，如果要为严重精神疾病患者提供充分的服务，就必须在管理式护理安排中继续发挥这一作用。
ObjectiveTo provide comprehensive information on expenditures for mental health and substance abuse services for a large number of people with severe mental illnesses, this study examined use of major types of clinical-medical mental health and psychiatric rehabilitation services over a one-year period.MethodsData were obtained for 1,890 clients in ten public county-based nonmetropolitan mental health systems in Wisconsin. Expenditures were for services provided with public funding, including local sources of funding, Medicaid, and Medicare. Data about services and expenditures were obtained from county records and unduplicated Medicaid claims for 12 months in 1989 and 1990.ResultsExpenditures per client averaged $10,995 for one year ($13,992 in 1994 dollars), with a maximum of $95,093. Expenditures for community-based outpatient services, including residential care and vocational services, represented 53.5 percent of all expenditures; residential care accounted for 12.4 percent and vocational services for 5.7 percent. Overall, 46.5 percent was spent for institutional care, with inpatient hospital care accounting for 12.6 percent. Approximately 40.6 percent of total expenditures were for services not typically covered under managed care plans.ConclusionsExpenditures for community-based care accounted for more than half of total expenditures. Expenditure patterns revealed the important role of social and rehabilitation services, a role that must be continued in managed care arrangements if they are to provide adequate services for people with severe mental illnesses.