Feldman Saul, Bachman John, Cuffel Brian, Friesen Bernice, McCabe John
United Behavioral Health, San Francisco, CA 94105, USA.
Adm Policy Ment Health. 2003 Jul;30(6):479-92; discussion 492-4. doi: 10.1023/a:1025025600989.
Access to behavioral health services, particularly pharmacotherapy, continues to be a significant problem. This is particularly the case for public sector beneficiaries and managed care members. The greater use of advanced practice psychiatric nurses (APPNs) with prescribing privileges could help. To better understand the availability and competence of APPNs to prescribe, the authors conducted 1) a national survey of APPNs' availability and prescribing practices, 2) a comparative analysis of pharmacy claims data generated by APPNs and psychiatrists, and 3) a comprehensive clinical record review comparing APPNs to psychiatrists. About 25% of the sample of APPNs reported having prescription authority and a private practice. The analysis of prescribing practices between APPNs and psychiatrists showed that with a few exceptions, there were no differences between the groups, as did a retrospective clinical record review. These results lead the authors to recommend greater efforts to increase the supply of APPNs.
获得行为健康服务,尤其是药物治疗服务,仍然是一个重大问题。对于公共部门受益人和管理式医疗成员来说,情况尤其如此。更多地使用具有处方权的高级执业精神科护士(APPN)可能会有所帮助。为了更好地了解APPN开处方的可及性和能力,作者进行了以下研究:1)对APPN的可及性和处方实践进行全国性调查;2)对APPN和精神科医生产生的药房索赔数据进行比较分析;3)对APPN和精神科医生进行全面的临床记录审查。约25%的APPN样本报告拥有处方权并从事私人执业。对APPN和精神科医生处方实践的分析表明,除了少数例外情况,两组之间没有差异,回顾性临床记录审查的结果也是如此。这些结果促使作者建议加大力度增加APPN的供应。