From many into one: Addressing the crisis of quality in managed behavioral health care at the millennium
From many into one: Addressing the crisis of quality in managed behavioral health care at the millennium
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从多到一：解决新千年管理行为卫生保健的质量危机
DOI：
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发表时间：
1998
影响因子：
1.9
通讯作者：
R. Manderscheid
中科院分区：
文献类型：
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作者：
R. Manderscheid
目前，来自精神卫生领域的报告表明，私营和公共部门对精神卫生保健的财政投资正在大幅下降。私营部门的下降速度更为显著，因为管理式医疗合同已经存在了较长一段时间。这是一个极其严重的问题——有些人会说这是一场危机——因为提供护理所需的资源正以极快的速度从心理健康领域流失。在这种情况下，价格是衡量精神卫生保健质量的唯一标准。双方同意的系统和临床实践指南、结果测量和报告卡无法以独立的方式记录精神卫生保健的质量。因此，实地无法与付款人进行有效的对话或谈判，对他们来说，价格即使不是唯一的考虑，也是主要的考虑。如果没有精神卫生领域所有团体的立即协调努力，这种情况有可能在较长时间内削弱甚至轻视精神卫生保健。
At present, reports from the mental health field indicate that the financial investment in mental health care is falling substantially in both the private and public sectors. The rate of decline is more dramatic in the private sector because managed care contracting has been extant there for a longer period of time. This is an extremely serious problem--some would say a crisis--because badly needed resources for care provision are eroding away from mental health at a rapid rate. In this context, price is the sole measure of quality of mental health care. Consensually agreedupon system and clinical practice guidelines, outcome measures, and report cards are not available to document quality of mental health care in an independent manner. Hence, the field cannot dialogue or negotiate effectively with payers, for whom price is a primary, if not the only, consideration. Without immediate coordinated effort by all groups in the mental health field, this situation has the potential to enfeeble, or even trivialize, mental health care over the longer tenn.