Alexander Jeffrey A, Lemak Christy Harris, Campbell Cynthia I
Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Mich., USA.
J Behav Health Serv Res. 2003 Oct-Dec;30(4):369-81. doi: 10.1007/BF02287425.
Using nationally representative data from 1995 and 2000, this study examines trends in managed care penetration and activity among outpatient drug treatment organizations in the United States. Further, it investigates how managed care activity varies across different types of treatment providers and for public and private managed care programs. Overall, managed care activity has increased, with a greater proportion of units having managed care arrangements and a larger percentage of clients covered by managed care. In general, public managed care activity has increased and private managed care activity has decreased. Treatment providers report that they have fewer managed care arrangements, which may reflect consolidation in the managed behavioral care sector. Finally, growth in managed care among outpatient substance abuse treatment units affiliated with hospitals and mental health centers may signal a preference for providers that can effectively link substance abuse treatment with medical and social service provision, or, alternatively, that linkages with such organizations may provide the size necessary to assume the risks associated with managed care contracts.
本研究利用1995年和2000年具有全国代表性的数据,考察了美国门诊药物治疗机构中管理式医疗渗透和活动的趋势。此外,还调查了管理式医疗活动在不同类型治疗提供者以及公共和私人管理式医疗项目中的差异情况。总体而言,管理式医疗活动有所增加,有管理式医疗安排的单位比例更高,管理式医疗覆盖的客户百分比也更大。一般来说,公共管理式医疗活动增加了,而私人管理式医疗活动减少了。治疗提供者报告称他们的管理式医疗安排减少了,这可能反映了行为管理医疗领域的整合。最后,与医院和心理健康中心相关的门诊药物滥用治疗单位中管理式医疗的增长,可能表明更倾向于能够有效将药物滥用治疗与医疗和社会服务提供相联系的提供者,或者说,与这些组织的联系可能提供了承担与管理式医疗合同相关风险所需的规模。