A needs-based method for estimating the behavioral health staff needs of community health centers
A needs-based method for estimating the behavioral health staff needs of community health centers
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DOI：
10.1186/1472-6963-13-245
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发表时间：
2013-07-02
影响因子：
2.8
通讯作者：
Phillips, Robert L.
中科院分区：
文献类型：
--
作者：
Burke, Bridget Teevan;Miller, Benjamin F.;Phillips, Robert L.
背景：联邦合格的健康中心正在扩大，以增加数百万美国人的服务机会，目标是将服务能力加倍，为 4000 万人提供服务。健康中心提供大量行为健康服务，但许多中心很难为患者找到心理健康和药物滥用专业人士。为了满足服务不足和新参保者的需求，更好地估计需要多少行为健康专业人员非常重要。方法：使用 2010 年统一数据系统和 2010 年全国药物使用和健康调查中的健康中心人员配置数据和行为健康服务模式，我们按保险类型估计了可能需要行为健康护理的患者人数、健康中心患者每年可能需要的就诊次数以及为其提供服务所需的全职等效提供者数量。结果：超过2010 年，250 万名 12 岁或以上患有轻度或中度精神疾病的患者以及超过 357,000 名药物滥用障碍患者可能得不到所需的行为健康服务。这种需求水平需要超过 11,600 名全职提供者。这意味着每 2,500 名患者中约有 0.9 名获得许可的心理健康服务提供者 FTE、0.1 名 FTE 精神科医生、0.4 名 FTE 其他心理健康工作人员以及 0.3 名 FTE 药物滥用提供者。这些估计表明，2010 年，90% 的现有中心无法获得心理健康服务或提供药物滥用服务来完全满足患者的需求。如果保健中心扩建后的需求类似，则将需要超过 27,000 名全职行为健康提供者来为 4000 万医疗患者提供服务，受资助者将需要将行为健康人员增加四倍以上。结论：初级保健中的行为健康问题比任何其他环境都多，健康中心客户比典型的初级保健有更大的行为健康需求患者。 2010 年，大多数卫生中心需要额外的行为健康服务，而这一需求将扩大到为 4000 万患者提供服务。需要对这些劳动力模型进行进一步测试，但目前服务不足的程度表明我们迫不及待地想继续缩小差距。
Background: Federally Qualified Health Centers are expanding to increase access for millions of more Americans with a goal of doubling capacity to serve 40 million people. Health centers provide a lot of behavioral health services but many have difficulty accessing mental health and substance use professionals for their patients. To meet the needs of the underserved and newly insured it is important to better estimate how many behavioral health professionals are needed.Methods: Using health center staffing data and behavioral health service patterns from the 2010 Uniform Data System and the 2010 National Survey on Drug Use and Health, we estimated the number of patients likely to need behavioral health care by insurance type, the number of visits likely needed by health center patients annually, and the number of full time equivalent providers needed to serve them.Results: More than 2.5 million patients, 12 or older, with mild or moderate mental illness, and more than 357,000 with substance abuse disorders, may have gone without needed behavioral health services in 2010. This level of need would have required more than 11,600 full time providers. This translates to approximately 0.9 licensed mental health provider FTE, 0.1 FTE psychiatrist, 0.4 FTE other mental health staff, and 0.3 FTE substance abuse provider per 2,500 patients. These estimates suggest that 90% of current centers could not access mental health services or provide substance abuse services to fully meet patients' needs in 2010. If needs are similar after health center expansion, more than 27,000 full time behavioral health providers will be needed to serve 40 million medical patients, and grantees will need to increase behavioral health staff more than four-fold.Conclusions: More behavioral health is seen in primary care than in any other setting, and health center clients have greater behavioral health needs than typical primary care patients. Most health centers needed additional behavioral health services in 2010, and this need will be magnified to serve 40 million patients. Further testing of these workforce models are needed, but the degree of current underservice suggests that we cannot wait to move on closing the gap.