MENTAL HEALTH SERVICES RESEARCH PROGRAM IN MANAGED CARE

描述(申请人摘要)：作为有组织的护理系统移动 朝着成为美国主要的医疗服务系统的方向发展， 管理型医疗组织正试图衡量和改善健康状况 每单位成本的结果(“价值”)。这个议程，今天的特点是 管理型医疗组织，在很大程度上是由于 期望医疗保健系统有序重组的市场 以尽可能低的成本实现效益最大化。哈佛朝圣者健康 CARE(HPHC)建议制定研究基础设施建设计划 精神卫生服务和临床研究的背景下的(RISP) 管理型医疗保健，补充和扩展现有的高度发达的 临床质量管理和改进周期的过程。建议数 工作将加速和促进不断涌现的心理健康 这个大型健康维护组织内的基础设施。它是 很可能是技能培养和多学科形成的过程 HPHC“发明”或开发的研究小组将适用于其他 管理型医疗组织。 拟议的RISP的具体目标是发展多学科小组 心理健康研究人员将：(1)研究组织、过程 以及初级保健中精神疾病护理的结果。这群人将会是 由HPHC不同部门的核心人员代表， 来自学术组织的研究人员，在心理方面有良好的记录 卫生研究和教育培训，以及来自 公共部门在定义和管理方面发挥越来越重要的作用 评估其客户的精神卫生保健；(2)探索机制，以 将初级保健提供者与精神健康专家联系起来，以改善 常见和昂贵的精神疾病的获得和护理结果 如抑郁症伴或不伴药物滥用；(3)检验实验 在重新组织提供精神卫生保健服务的工作人员和 医疗集团HPHC组件以改善患者和提供者 满意度和关爱(“混合模式”)；(4)检查患者因素 与访问相关，特别是针对患者的干预 在促进进入传统健康和精神健康计划方面， (5)最后，为了研究公共保险成员的特殊需要， 特别是医疗补助人群，他们的特点是 严重和慢性精神疾病的比例过高，如 精神分裂症和严重的情感障碍。

DESCRIPTION (Applicant's Abstract): As organized systems of care move towards becoming the predominant form of health delivery system in the U.S., managed care organizations are attempting to measure and improve health outcomes per unit cost ("value"). This agenda, characteristic of today's managed care organization, is due in large part to the demands of the marketplace which expects reorganization of the health care system in order to maximize benefit at the lowest possible cost. Harvard Pilgrim Health Care (HPHC) proposes to develop a research infrastructure building program (RISP) of mental health services and clinical research in the context of managed care which complements and extends an existing and highly developed process of clinical quality management and improvement cycles. The proposed work will accelerate and facilitate a continuously emerging mental health infrastructure within this large health maintenance organization. It is likely that processes of skill-building and formation of multidisciplinary research groups "invented" or developed at HPHC will be applicable to other managed care organizations. Specific aims of the proposed RISP are to develop multidisciplinary groups of mental health researchers that will: (1) study the organization, process and outcomes of care for mental illness in primary care. This group will be represented by core individuals from within the different divisions of HPHC, researchers from academic organizations with a solid track record in mental health research and educational training, and representatives from the public sector who are increasingly important actors in defining and evaluating mental health care for their clients; (2) explore mechanisms to link primary care providers to mental health specialists in order to improve access to and outcomes of care for common and expensive mental illnesses such as depression with or without substance abuse; (3) examine experiments in the re-organization of mental health care delivery within staff and medical groups components of HPHC to improve patient and provider satisfaction and care ("hybrid models"); (4) examine patient factors associated with access and particularly patient-directed interventions aimed at facilitating entry into traditional health and mental health programs, (5) and, finally to study the special needs of publicly-insured members, especially Medicaid populations which are characterized by disproportionately high levels of serious and chronic mental illness such as schizophrenia and major affective disorders.