MODELING UTILIZATION OF CHILD RESIDENTIAL TREATMENT

人们对高使用率表示了极大的关注 公立和私立的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，并且是 成本如此之高，以至于耗尽了本已稀缺的财政资源。 居民精神卫生治疗的程度远远大于 以前实现的一次更广泛的系统视角，包括 初级医疗部门被考虑。需要对这些因素进行研究 与使用率和使用模式相关联，以便 能够更成功地塑造未来的护理体系。 此外，为成人心理健康开发了利用模式 治疗需要针对儿童和青少年进行改进和测试 人口。这项研究计划旨在开始填补这样的空白 关于服务系统问题的数据库。 拟议的研究计划响应了NIMH对服务的呼吁 研究以评估和改进效率、组织、交付、 儿童和儿童获得治疗和预防服务的机会 患有精神障碍的青少年。持续较高的利用率 限制性和昂贵的住院治疗环境(即住院患者 医院和居民治疗中心)对大规模的 在这些设置中消耗的资源量，并危及工作 实施以社区为基础的护理制度。公共与学术的联络人 模型将用于满足关键的研究需求并构建 研究能力。这些目标将通过以下方式实现： 1.调整精神卫生治疗利用模式，以 儿童和青少年的住院治疗；以及 2.将该模型应用于儿童和青少年人口。 通过第一个奖项，提出了一个为期五年的研究计划 住院医院和住院部利用研究计划 儿童心理健康问题治疗中心和 国家为其提供照料的青少年。状态心理机制 医疗保健包括：直接提供精神状态下的住院护理 医院、作为监护人的儿童的监管和责任 用于获取和支付医疗费用，以及住院患者的公共费用 通过医疗补助计划提供的服务。日常收集的数据由 国家将在这些领域进行整合，接受质量检查，并 在两步模型中用于确定入院概率 居民待遇和利用水平。停留时间和停留时间 累犯也将被审查。有关相关费用的信息 这些环境中的精神健康治疗将作为次要内容包括在内 全神贯注。

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.