MODELING UTILIZATION OF CHILD RESIDENTIAL TREATMENT

儿童寄宿治疗利用情况建模

• 批准号: 2249449
• 负责人: CRAIG ANNE HEFLINGER
• 金额: $ 10.56万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-05-01 至 1998-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2249449
• 关键词: adolescence (12-20); child (0-11); child mental health service; health care cost /financing; health care model; health care service evaluation; hospital analysis; hospital length of stay; hospital utilization; human subject; interview; medical records; mental health facility; model design /development; relapse /recurrence; residential care facility

Much concern has been expressed about the high utilization rates of mental hospitals, both public and private, for children and adolescents in our nation. These restrictive settings may not meet the needs of many of the children so placed, perhaps causing harm in some cases, and are so expensive that they deplete what are already scarce fiscal resources. The extent of residential mental health treatment is much greater than previously realized once a broader system perspective that includes the primary medical sector is considered. Studies are needed on the factors associated with utilization and patterns of utilization in order to be able to more successfully shape systems of care in the future. Furthermore, models of utilization developed for adult mental health treatment need to be modified for and tested on child and adolescent populations. This program of research aims to begin filing such gaps in the data base regarding service systems issues. The proposed program of research responds to NIMH's call for services research to evaluate and improve the efficacy, organization, delivery, and accessibility of treatment and prevention services to children and adolescents with mental disorders. The continued high utilization of restrictive and expensive residential treatment settings (i.e., inpatient hospitals and residential treatment centers) contributes to the massive amount of resources consumed in those settings and jeopardizes efforts to implement a community-based system of care. A public-academic liaison model will be used to address critical research needs and to build research capacity. The goals will be realized by: 1. adapting a model of mental health treatment utilization to residential treatment for children and adolescents; and 2. applying the model to a child and adolescent population. A five-year program of research is proposed through the FIRST Award program to study utilization of inpatient hospitals and residential treatment centers for the mental health problems of children and adolescents for whom the State provides care. Mechanisms of State mental health care include: direct provision of inpatient care in State mental hospitals, supervision of children as custodian and responsibility for accessing and paying for care, and public payment for inpatient services through the Medicaid program. Data collected routinely by the State in these areas will be integrated, subjected to quality checks, and used in a two step model for determining the probability of admission to residential treatment and the level of utilization. Length of a stay and recidivism will also be examined. Information on associated charges for mental health treatment in these settings will be included as a secondary focus.

人们对高利用率表示了极大的关注， 公立和私立儿童和青少年精神病院 在我们国家 这些限制性设置可能无法满足许多人的需求， 这样安置的儿童，在某些情况下可能造成伤害， 如此昂贵，耗尽了本已稀缺的财政资源。 住院精神健康治疗的范围远远大于 以前实现过一次更广泛的系统视角，包括 考虑到初级医疗部门。 需要对这些因素进行研究 与利用率和利用模式相关， 能够在未来更成功地塑造护理系统。 此外，成人心理健康的利用模式 治疗需要修改，并在儿童和青少年身上进行测试 人口。 这项研究计划旨在开始填补这些空白， 关于服务系统问题的数据库。 拟议的研究计划响应了NIMH的服务号召 研究，以评估和改善效率，组织，交付， 以及儿童获得治疗和预防服务的机会， 青少年精神障碍 持续的高利用率 限制性和昂贵的住宅治疗设置（即，住院 医院和住院治疗中心） 在这些环境中消耗的资源数量，并危及 实施以社区为基础的护理系统。 一个公共学术联络人 模型将用于解决关键的研究需求，并建立 研究能力。 将通过以下方式实现这些目标： 1.调整心理健康治疗利用模式， 为儿童及青少年提供住院治疗;及 2.将该模型应用于儿童和青少年群体。 通过FIRST奖提出了一项为期五年的研究计划 研究住院医院和住宅利用率的计划 儿童心理健康问题治疗中心， 国家给予照顾的青少年。 心理状态的机制 保健包括：在州精神病院直接提供住院治疗 医院，儿童的监督， 保管人和责任 用于获得和支付护理，以及住院病人的公共支付 通过医疗补助计划。 数据由 这些领域的国家将被整合，接受质量检查， 在两步模型中使用，用于确定 居民待遇和利用水平。 停留时间和 并会研究累犯的情况。 有关以下方面的相关费用的资料： 在这些环境中的心理健康治疗将被列为次要的 专心点