Lopiccolo Charles J, Eldon Taylor C, Clemence Cheryl, Eisdorfer Carl
Dr. Lopiccolo is Medical Director, University of Miami Behavioral Health, Associate Professor and Vice Chairman, Department of Psychiatry and Behavioral Sciences.
Psychiatry (Edgmont). 2005 Jan;2(1):43-6.
The objective of this study was to examine the adherence rates of psychiatrists with APA standards for coordination of care in split treatment. Coordination of care in split treatment is monitored from claims paid data in an academic MBHO as an ongoing quality improvement activity. For an 18-month period, 93 psychiatrists were identified with 559 patients in split treatment and were mailed a survey. Surveys were controlled for change of providers. Self-report survey results were obtained from 69 psychiatrists for 295 patients in split treatment. The average rate of coordination was 66 percent; however, the distribution was bimodal with 36 percent of psychiatrists always coordinating and 26 percent never coordinating. Not obtaining a release accounted for 87 percent of non-coordination. In conclusion, while coordination of care in split treatment is an APA standard of practice, only 36 percent of psychiatrists fully complied. That one third of patients in split treatment did not receive coordinated care suggests a need for improvement to meet the APA standards of practice and avoid legal exposure.
本研究的目的是检验精神科医生在分开治疗中遵循美国精神病学协会（APA）护理协调标准的比率。在一家学术性的管理式行为健康组织（MBHO）中，从已支付的理赔数据监测分开治疗中的护理协调情况，将其作为一项持续的质量改进活动。在18个月的时间里，识别出93名有559名接受分开治疗患者的精神科医生，并向他们邮寄了一份调查问卷。调查问卷针对提供者变更进行了控制。从69名精神科医生那里获得了关于295名接受分开治疗患者的自我报告调查结果。护理协调的平均比率为66%；然而，分布呈双峰型，36%的精神科医生总是进行协调，26%的精神科医生从不进行协调。未获得授权占非协调情况的87%。总之，虽然分开治疗中的护理协调是APA的一项执业标准，但只有36%的精神科医生完全遵守。三分之一接受分开治疗的患者未得到协调护理，这表明需要改进以符合APA的执业标准并避免法律风险。
