RELATIONSHIPS BETWEEN GEN MED & MENTAL HLTH SPECIALTY

GEN MED 之间的关系

• 批准号: 3384037
• 负责人: DAVID MECHANIC
• 金额: $ 16.87万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-02-01 至 1991-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3384037
• 关键词: culture; disabling disease; disease /disorder proneness /risk; health care service planning; health care service utilization; health surveys; human subject; mental disorder diagnosis; mental disorders; mental health epidemiology; mental health services; patient care management; psychological models

This project will develop a synthetic model of the selection of patients with psychiatric disorders into general medical and specialty mental health care and examine the content of care in varying outpatient and inpatient settings using data from major national studies )ECA, Rand Health Insurance Experiment, Marshfield Epidemiological Survey, National Ambulatory Medical Care Survey) and State data sets on inpatient care. Before embarking on a new generation of expensive studies on need for care, selection into treatment, and the content of care, thorough efforts will be made to use existing data to develop a predictive selection model, and test and refine it across varying studies. The proposed selection model is based on the assumption that concepts of need should not be based on illness prevalence alone, but also on subjective distress, levels of disability and impairment, and consequences of symptoms for risk and burden. We also believe that social and cultural constraints must be taken into account in understanding responses to need. We propose a selection model based on eight classes of indicators: (1) DIS/DSM-III deagnosis or other measures of psychological disturbance; (2) severity of distress; (3) degree of risk as in violence, explosive behavior or suicide threat; (4) physical co-morbidity; (5) disruptive effects of the illness on work and family; (6) psychological propensities toward psychological and /or specialty mental health care; (7) characteristics of the medical care system including financial access and specialty sector resources available; and (8) cultural characteristics of the geographic area. By conducting parallel analyses across varying data sets using different operational definitions we plan to identify robust and more uncertain patterns. The proposed model, we believe, will not only assist in assissing need and planning services but should be helpful in explaining differences in resource consumption among seemingly comparable patients.

该项目将开发一个综合模型， 患有精神疾病的患者进入普通医疗机构， 专业心理卫生保健和检查护理的内容， 不同的门诊和住院设置使用的数据，从主要 非洲经委会，兰德健康保险实验，马什菲尔德 流行病学调查，全国门诊医疗调查） 和关于住院病人护理的国家数据集。 在开始一个新的 产生昂贵的研究需要照顾，选择到 治疗和护理的内容，将彻底努力 使用现有数据开发预测选择模型，以及 在不同的研究中测试和完善它。 建议的选择 模型基于这样的假设，即需要的概念不应该 不仅基于疾病流行率，而且基于主观 痛苦，残疾和损伤程度，以及 风险和负担的症状。 我们还认为， 在理解时必须考虑到文化限制 对需求的回应。 我们提出了一个选择模型的基础上，八个 指标分类：（1）DIS/DSM-III诊断或其他措施 （2）抑郁的严重程度;（3）抑郁的程度 有暴力、爆炸性行为或自杀威胁的风险;（4） 身体共病;（5）疾病对 工作和家庭;（6）心理倾向， 心理和/或专业精神卫生保健;（7） 医疗保健系统的特点，包括财政 可获得的准入和专业部门资源;以及（8）文化 地理区域的特点。 通过进行平行 使用不同的操作数据集进行分析 定义我们计划识别稳健和更不确定的模式。 我们认为，拟议的模式不仅有助于协助 需要和规划服务，但应有助于解释 资源消耗的差异似乎可比 患者