Jerrell J M, Ridgely M S
University of South Carolina School of Medicine, USA.
Behav Healthc Tomorrow. 1997 Jun;6(3):26-33.
People with severe and persistent mental illnesses frequently suffer from addictive disorders as well. Managed care plans and at-risk providers who care for people with these conditions must understand, authorize, and provide evidence-based and cost-effective care. The authors of this article evaluated three specialized interventions for treating people with co-occurring severe mental illness and substance abuse. Treatment of both disorders was found to be essential. In addition, a behavioral skills training was found to improve outcomes and reduce total healthcare costs when compared with intensive case management and 12-Step recovery interventions. Supplemental supportive services further increase the overall value of care. Implications for managed care and at-risk providers are discussed.
患有严重且持续性精神疾病的人也经常患有成瘾性障碍。负责照顾这些患者的管理式医疗计划和风险承担型医疗服务提供者必须了解、批准并提供基于证据且具有成本效益的治疗。本文作者评估了三种针对同时患有严重精神疾病和药物滥用的患者的专门干预措施。结果发现,对这两种疾病的治疗都至关重要。此外,与强化个案管理和12步康复干预措施相比,行为技能培训被发现可以改善治疗效果并降低总体医疗成本。补充性支持服务进一步提高了护理的整体价值。文中还讨论了对管理式医疗和风险承担型医疗服务提供者的启示。