Schinnar A P, Kamis-Gould E, Delucia N, Rothbard A B
Wharton School, University of Pennsylvania, Philadelphia 19104-6197.
Health Serv Res. 1990 Jun;25(2):387-420.
The use of partial care as a treatment modality for mentally ill patients, particularly the chronically mentally ill, has greatly increased. However, research into what constitutes a "good" program has been scant. This article reports on an evaluation study of staff productivity, cost efficiency, and service effectiveness of adult partial care programs carried out in New Jersey in fiscal year 1984/1985. Five program performance indexes are developed based on comparisons of multiple measures of resources, service activities, and client outcomes. These are used to test various hypotheses regarding the effect of organizational and fiscal variables on partial care program efficiency and effectiveness. The four issues explored are: auspices, organizational complexity, service mix, and fiscal control by the state. These were found to explain about half of the variance in program performance. In addition, partial care programs demonstrating midlevel performance with regard to productivity and efficiency were observed to be the most effective, implying a possible optimal level of efficiency at which effectiveness is maximized.
作为一种针对精神病患者,尤其是慢性精神病患者的治疗方式,部分护理的使用已大幅增加。然而,对于构成一个“优质”项目的要素的研究却很少。本文报告了一项于1984/1985财政年度在新泽西州开展的针对成人部分护理项目的员工生产力、成本效益和服务效果的评估研究。基于对资源、服务活动和客户结果的多种衡量指标的比较,制定了五个项目绩效指标。这些指标用于检验关于组织和财政变量对部分护理项目效率和效果的影响的各种假设。所探讨的四个问题是:主办机构、组织复杂性、服务组合以及州政府的财政控制。结果发现,这些因素解释了项目绩效约一半的差异。此外,观察到在生产力和效率方面表现为中等水平的部分护理项目是最有效的,这意味着可能存在一个使效果最大化的最佳效率水平。