COSTS/OUTCOMES OF CALIF MH CAPITATION EXPERIMENT

这项提议将加强对 加利福尼亚州资助的测试创新服务的演示 为严重精神病患者提供的交付和融资(按人头计算)计划 在两个县生病(SMI)。本提案中涉及的评估 涉及两个地点的随机比较试验 服务机构“(ISA)和现有服务系统下的日常护理。 这项研究工作将与国家资助的 评估承包商(列文/ICF公司)。我们的建议旨在：1) 从ISA提供商以外的机构收集额外的成本数据 家庭负担和工作人员流程评估的主题；2)分析 实验的成本和结果从社会背景到 补充国家资助机构的背景；3)分析 ISA试点与使用常规护理系统的成本进行比较 最先进的统计模型。 这份修订后的提案是为了回应以下建议而撰写的 服务业研究检讨小组委员会在一九九零年九月 摘要声明。 这项研究将显著扩大和完善国家资助的 分析计划，为两个受众产生结果。第一，国家和 国家政策制定者将进行成本效益分析，即 有足够的可靠性和精确度来提出长期的政策建议。 其次，研究界将能够获得：社会成本- 效率分析战略，呈现出状态的进步- 与现有的公费大写字母研究相比较 SMI的服务交付系统；以及解决以下问题的调查结果 在经验知识方面的差距，关于这种成本和结果 金融和服务提供创新。

This proposal will strengthen the evaluation of one component of a California State-funded demonstration that tests an innovative service delivery and financing (capitation) program for the severely mentally ill (SMI) in two counties. The evaluation addressed in this proposal involves a two-site randomized comparison between the pilot "Integrated Services Agency" (ISA) and usual care under the existing service system. This research effort will be undertaken jointly with the State-funded evaluation contractor (Lewin/ICF Inc). Our proposal is designed to: 1) collect additional cost data from agencies other than ISA providers on the topics of family burden and staff process evaluation; 2) analyze the cost and outcomes of the experiment from the societal context to complement the State-funding agency context and; 3) analyze the costs of the ISA pilots as compared to the costs of the usual care system using state-of-the-art statistical models. This revised proposal is written in response to recommendations made by the Services Research Review Subcommittee in their September 1990 Summary Statement. This study will significantly expand and improve the State-funded analysis plan, producing results for two audiences. First, state and national policy makers will have a cost-effectiveness analysis that is reliable and precise enough to make long-term policy recommendations. Second, the research community will have access to: a societal cost- effectiveness analysis strategy that presents an advance in the state- of-the-art compared with existing studies of publically funded capitated service delivery systems for the SMI; and findings that will address the gap in empirical knowledge regarding the costs and outcomes of such finance and service delivery innovations.