WELFARE REFORM & USE OF MENTAL HEALTH SERVICES BY WOMEN

社会福利改革

• 批准号: 6071307
• 负责人: Dannia G. Southerland
• 金额: $ 2.49万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-01-01 至 2000-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6071307
• 关键词: Medicare /Medicaid; behavioral /social science research tag; drug abuse therapy; female; health care cost /financing; health care policy; health care service utilization; health services research tag; human data; longitudinal human study; low socioeconomic status; mathematical model; mental health services; model design /development; psychosocial service; public assistance; social model; social service; substance abuse related disorder; women's health

There is increasing recognition that a subset of women on welfare face multiple barriers to work and self-sufficiency. The consequences of welfare reform are likely to be extremely negative for the subpopulation of women heads-of-households with mental health and/or substance abuse related disorders. In particular, access to services by this at-risk population may be in jeopardy as a consequence of current welfare reforms. This begs a critical empirical question: How will the mental health service delivery system accommodate the needs of this at-risk population? Adequately understanding the forces affecting the utilization patterns of poor women using behavioral health services is critical for developing strategies to influence the utilization patterns of poor women using behavioral health services is critical for developing strategies to influence the impact of policy changes on access to services by this at risk population. This proposal deals with phase one of a study that will develop a longitudinal database and multivariate research methodology to examine changes to patterns of mental health and substance abuse care for the target population of poor women eligible for Medicaid based historically on receipt of Aid to Families with Dependent Children (AFDC), and now Temporary Assistance for Needy Families (TANF). The study will accomplish two interrelated objectives: (1) Provide an understanding of what factors explain the patterns of care of poor women heads-of-households receiving Medicaid mental health and substance abuse services; and (2) provide information to guide development of intervention strategies to improve access to and quality of mental health services for this at risk population, in the wake of major social welfare and health policy reformulation. This research fits into a larger, long term research agenda focused on providing information about both the impact of these policy reforms on the lives of women heads-of-households with mental health needs, and the mental health and larger human service system changes that must be undertaken to improve outcomes for this subset of the welfare population. Medicaid claims data will be combined with administrative data in an analysis of utilization patterns of the study population, including both system and service recipient characteristics. The following research questions will be addressed. 1. What are the patterns of care of this population (descriptive); and 2. What client and systems characteristics explain the patterns of care (explanatory)?

人们日益认识到，一部分领取福利的妇女在工作和自给自足方面面临多重障碍。福利改革的后果可能对患有精神健康和/或药物滥用相关疾病的女户主这一亚群体极为不利。特别是，由于目前的福利改革，这一高危人群获得服务的机会可能受到威胁。这就引出了一个关键的经验问题：精神卫生服务提供系统将如何满足这一高危人群的需求？正确理解影响贫困妇女利用行为健康服务的力量是至关重要的，制定战略，影响贫困妇女利用行为健康服务的模式是至关重要的，制定战略，影响政策变化对获得服务的影响，这在风险人口。该提案涉及一项研究的第一阶段，该研究将开发一个纵向数据库和多变量研究方法，以检查有资格获得医疗补助的贫困妇女目标人群的心理健康和药物滥用护理模式的变化，该目标人群的心理健康和药物滥用护理模式的变化基于历史上接受的有受抚养子女家庭援助（AFDC），现在是贫困家庭临时援助（TANF）。这项研究将实现两个相互关联的目标：（1）了解哪些因素解释了接受医疗补助精神健康和药物滥用服务的贫困女户主的护理模式;和（2）提供信息，指导制定干预战略，以改善这一高危人群获得精神卫生服务的机会和质量，在社会福利及卫生政策作出重大改革后，这项研究适合一个更大的，长期的研究议程，重点是提供有关这些政策改革对有心理健康需求的女户主的生活的影响，以及必须进行的心理健康和更大的人类服务系统的变化，以改善福利人口的这一子集的结果。医疗补助索赔数据将与管理数据相结合，分析研究人群的利用模式，包括系统和服务接受者的特征。将讨论以下研究问题。1.该人群的护理模式是什么（描述性的）;以及2.什么样的客户和系统特征可以解释护理模式（解释性）？