Wright Eric R, Kooreman Harold E, Anderson Jeffrey A
Department of Public Health, Indiana University Center for Health Policy, Indiana University School of Medicine, 714 N. Senate Avenue, EF 200, Indianapolis, IN, 46202, USA,
J Behav Health Serv Res. 2014 Oct;41(4):488-502. doi: 10.1007/s11414-012-9281-3.
A major challenge in the implementation of systems of care is creating mechanisms to pay for services that are provided across social services systems and by multiple agencies. Using a managed care approach to coordinate service provision may be one way to effectively bridge the gap across agencies while also providing quality care. The authors explore the benefits of a managed care approach to service delivery within a well established system of care by describing the treatment planning process used by the system of care; describing the type and patterns of services provided to young people; and by describing the process used to bill for services. The authors also examine the impact of client and service characteristics on overall expenditures as well as the effect that patterns of service utilization and expenditures of care have on the likelihood that young people and their families will successfully meet their clinical objectives.
实施照护体系面临的一项重大挑战是建立机制,为跨社会服务体系且由多个机构提供的服务付费。采用管理式照护方法来协调服务提供,可能是有效弥合各机构间差距并提供优质照护的一种方式。作者们通过描述照护体系所采用的治疗规划流程、描述为年轻人提供的服务类型和模式以及描述服务计费流程,探讨了在成熟的照护体系中采用管理式照护方法进行服务提供的益处。作者们还研究了服务对象和服务特征对总支出的影响,以及服务利用模式和照护支出对年轻人及其家庭成功实现临床目标可能性的影响。