Horvitz-Lennon Marcela, Donohue Julie M, Domino Marisa E, Normand Sharon-Lise T
Western Psychiatric Institute and Clinic, University of Pittsburgh (Pennsylvania) Medical School, USA.
Health Aff (Millwood). 2009 May-Jun;28(3):701-12. doi: 10.1377/hlthaff.28.3.701.
The slow spread of treatments supported by empirical evidence and the rapid diffusion of treatments lacking such support play major roles in the lower quality of mental health care received by people with severe mental illnesses compared with the care of less severely ill people. Further, the rapid spread of treatments that are of low cost-effectiveness limits the system's ability to provide the full gamut of high-value treatments available to treat this vulnerable population. Using the case of schizophrenia, we review the context in which these paradoxical patterns of diffusion have occurred, and we propose policy solutions.
与病情较轻者的护理相比,有实证依据支持的治疗方法传播缓慢,而缺乏此类支持的治疗方法却迅速扩散,这在重症精神疾病患者接受的心理健康护理质量较低方面起到了主要作用。此外,成本效益低的治疗方法迅速传播,限制了系统为治疗这一弱势群体提供全套高价值治疗方法的能力。我们以精神分裂症为例,回顾了这些矛盾的传播模式出现的背景,并提出了政策解决方案。