How cost sharing affects the use of ambulatory mental health services.
How cost sharing affects the use of ambulatory mental health services.
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费用分摊如何影响门诊心理健康服务的使用。
DOI：
10.1001/jama.1986.03380140100030
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发表时间：
1986
期刊：
影响因子：
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通讯作者：
J. Ware
中科院分区：
文献类型：
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作者：
W. Manning;K. Wells;N. Duan;J. Newhouse;J. Ware
精神卫生保健保险覆盖范围的不那么慷慨引起了一些争议。尚未解决的主要问题是门诊精神卫生保健的需求如何应对成本分摊。我们使用针对非老年人按服务收费的健康保险随机试验的数据来解决这个问题。该研究招募了 5809 人。结果基于 19 819 人年的数据。当患者免费接受护理时，门诊心理治疗的花费比支付 95% 的费用时多出 133%（受到年度灾难性限额的限制）。但是，所有计划的绝对支出水平都很低；每人每年 32 美元，免费护理。心理治疗服务对费用分摊的反应略高于门诊普通医疗服务。我们没有发现任何证据表明门诊心理治疗的更慷慨的覆盖会减少总医疗支出。
The less generous insurance coverage for mental health care has generated some controversy. The major unresolved question is how the demand for outpatient mental health care responds to cost sharing. We used data from a randomized trial of fee-for-service health insurance for the nonelderly to address this question. The study enrolled 5809 persons. The results are based on 19 819 person-years of data. One hundred thirty-three percent more is spent on outpatient psychotherapy when care is free to patients than when they pay 95% of the fee, subject to an annual catastrophic limit. But, the absolute level of expenditure is low on all plans; $32 per person per year with free care. The response to psychotherapy services to cost sharing is insignificantly larger than that for outpatient general medical services. We found no evidence that more generous coverage for outpatient psychotherapy decreases total health expenditures.