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.

人们对高利用率的高利用率表示关注 儿童和青少年的精神病院，无论是公立还是私立的 在我们的国家。 这些限制性设置可能无法满足许多人的需求 在某些情况下，在某些情况下可能造成伤害的孩子，并且 如此昂贵，以至于他们耗尽了已经稀缺的财政资源。 住宅心理健康治疗的程度远大于 以前已经意识到曾经是更广泛的系统观点，其中包括 考虑了初级医疗部门。 需要研究因素 与利用和利用模式相关联 能够在未来更成功地塑造护理系统。 此外，开发了用于成人心理健康的利用模型 需要对儿童和青少年进行修改并测试治疗 人群。 该研究计划旨在开始在 有关服务系统问题的数据库。 拟议的研究计划响应了NIMH的服务呼吁 评估和提高疗效，组织，交付， 以及对儿童的治疗和预防服务的可及性 精神障碍的青少年。 持续的高利用 限制性且昂贵的住宅治疗环境（即住院 医院和住宅治疗中心）有助于大规模 在这些设置中消耗的资源数量，并危害努力 实施基于社区的护理系统。 公共学术联络 模型将用于满足关键研究需求并建立 研究能力。 目标将通过： 1。调整心理健康治疗模型的模型 儿童和青少年的住院治疗；和 2。将模型应用于儿童和青少年人口。 第一个奖项提出了五年的研究计划 研究住院医院和住宅的利用计划 儿童心理健康问题的治疗中心 国家提供照顾的青少年。 国家精神机理 医疗保健包括：直接在州精神上提供住院护理 医院，对儿童作为保管人的监督和责任 用于访问和支付护理，以及住院的公共付款 通过医疗补助计划提供服务。 数据通常由 这些领域的状态将集成，进行质量检查，并进行 在两个步骤模型中用于确定入院的可能性 住宅处理和利用水平。 住宿的长度 还将检查累犯。 有关相关费用的信息 在这些情况下的心理健康治疗将被包括在内 重点。