The relationship between insurance coverage and psychiatric disorder in predicting use of mental health services.
The relationship between insurance coverage and psychiatric disorder in predicting use of mental health services.
复制标题
保险范围与精神疾病在预测心理健康服务使用方面的关系。
DOI：
10.1176/ajp.151.12.1785
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
George,LK
中科院分区：
文献类型：
--
作者：
Landerman,LR;Burns,BJ;Swartz,MS;Wagner,HR;George,LK
目的本研究探讨心理健康服务的保险覆盖率如何影响有或没有DSM-III精神病诊断的患者门诊心理健康服务的利用。作者使用一个有代表性的社区样本来比较保险覆盖率对这些受试者心理健康服务利用的回归效应。方法数据来自流行病学集水区项目在北卡罗莱纳州皮埃蒙特的第二波调查。这些数据包含了DSM-III的诊断方法，这些方法来源于国家精神卫生研究所诊断访谈时间表，以及保险覆盖范围和使用情况的方法。采用普通最小二乘法和logistic回归对2889名社区居民的反馈进行了分析。结果在两种模型中，保险覆盖率与精神障碍患者和非精神障碍患者的护理密切相关。在疾病患者中，覆盖率和护理概率之间的关联最为明显。结论该研究结果不符合未提供保险覆盖将减少可自由支配但非必要的精神卫生保健利用的说法。他们提供的证据表明，不提供保险覆盖将减少精神疾病患者的使用率，其程度不亚于无精神疾病患者。这一结果对医疗改革具有重要意义。
ObjectiveThis study investigated how insurance coverage for mental health services affects outpatient mental health service utilization among those with and among those without a DSM-III psychiatric diagnosis. The authors used a representative community sample to compare the regression effects of insurance coverage on utilization of mental health services among these subjects.MethodData are from the second wave of the Piedmont, North Carolina, site of the Epidemiologic Catchment Area project. These data contain DSM-III diagnostic measures derived from the National Institute of Mental Health Diagnostic Interview Schedule as well as measures of insurance coverage and utilization. Responses from 2,889 community residents were analyzed using both ordinary least squares and logistic regression.ResultsIn both models, insurance coverage was strongly associated with care among those with as well as among those without a psychiatric disorder. The association between coverage and the probability of care was strongest among those with a disorder.ConclusionsThe findings are not consistent with the claim that failing to provide insurance coverage will reduce discretionary but not necessary mental health care utilization. They provide evidence that failing to provide insurance coverage will reduce utilization as much or more among those with a psychiatric disorder as among those without. This result has important implications for health care reform.