Snowden Lonnie R, Masland Mary C, Wallace Neal T, Evans-Cuellar Allison
School of Social Welfare and the Center for Mental Health Services Research, Institute of Personality and Social Research, University of California, Berkeley, CA 94720-7400, USA.
Am J Public Health. 2007 Nov;97(11):1951-6. doi: 10.2105/AJPH.2006.094771. Epub 2007 Feb 28.
We investigated enforcement of mental health benefits provided by California Medicaid's Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Enforcement, compelled by a consumer-driven lawsuit, resulted in an almost 4-fold funding increase over a 5-year period. We evaluated the impact of enforcement on outpatient treatment intensity (number of visits per child) and rates of emergency care treatment. Using fixed-effects regression, we examined the number of outpatient mental health visits per client and the percentage of all clients using crisis care across 53 autonomous California county mental health plans over 32 three-month periods (quarters; emergency crisis care rates) and 36 quarters (out-patient mental health visits). Enforcement of EPSDT benefits in accordance with federal law produced favorable changes in patterns of mental health service use, consistent with policy aims.
我们调查了加利福尼亚医疗补助计划的早期定期筛查、诊断和治疗（EPSDT）项目所提供的心理健康福利的执行情况。在一场由消费者发起的诉讼推动下，执行工作使得在五年内资金增加了近四倍。我们评估了执行工作对门诊治疗强度（每个儿童的就诊次数）和急诊治疗率的影响。通过固定效应回归分析，我们考察了53个独立的加利福尼亚县心理健康计划在32个三个月时间段（季度；紧急危机护理率）和36个季度（门诊心理健康就诊）内每位客户的门诊心理健康就诊次数以及使用危机护理的所有客户的百分比。按照联邦法律执行EPSDT福利带来了心理健康服务使用模式的有利变化，这与政策目标一致。
