NIATx, University of Wisconsin-Madison, 1513 University Ave, Madison, WI 53715, USA.
Subst Abuse Treat Prev Policy. 2012 May 2;7:16. doi: 10.1186/1747-597X-7-16.
The Patient Protection and Affordable Care Act (PPACA) aims to provide affordable health insurance and expanded health care coverage for some 32 million Americans. The PPACA makes provisions for using technology, evidence-based treatments, and integrated, patient-centered care to modernize the delivery of health care services. These changes are designed to ensure effectiveness, efficiency, and cost-savings within the health care system.To gauge the addiction treatment field's readiness for health reform, the authors developed a Health Reform Readiness Index (HRRI) survey for addiction treatment agencies. Addiction treatment administrators and providers from around the United States completed the survey located on the http://www.niatx.net website. Respondents self-assessed their agencies based on 13 conditions pertinent to health reform readiness, and received a confidential score and instant feedback.On a scale of "Needs to Begin," "Early Stages," "On the Way," and "Advanced," the mean scores for respondents (n = 276) ranked in the Early Stages of health reform preparation for 11 of 13 conditions. Of greater concern was that organizations with budgets of < $5 million (n = 193) were less likely than those with budgets > $5 million to have information technology (patient records, patient health technology, and administrative information technology), evidence-based treatments, quality management systems, a continuum of care, or a board of directors informed about PPACA.The findings of the HRRI indicate that the addiction field, and in particular smaller organizations, have much to do to prepare for a future environment that has greater expectations for information technology use, a credentialed workforce, accountability for patient care, and an integrated continuum of care.
《患者保护与平价医疗法案》（PPACA）旨在为 3200 万美国人提供负担得起的医疗保险和更广泛的医疗保健覆盖范围。PPACA 规定利用技术、基于证据的治疗方法和综合的、以患者为中心的护理来实现医疗服务的现代化。这些变化旨在确保医疗保健系统的有效性、效率和成本节约。
为了评估成瘾治疗领域对医疗改革的准备情况，作者为成瘾治疗机构开发了一个健康改革准备指数（HRRI）调查。来自美国各地的成瘾治疗管理员和提供者在 http://www.niatx.net 网站上完成了调查。受访者根据与健康改革准备相关的 13 个条件，对自己的机构进行自我评估，并获得了保密的分数和即时反馈。
在“需要开始”、“早期阶段”、“在路上”和“先进”的评分范围内，受访者（n=276）在 13 个条件中的 11 个方面的健康改革准备程度得分为早期阶段。更令人担忧的是，预算低于 500 万美元的组织（n=193）比预算超过 500 万美元的组织更不可能拥有信息技术（患者记录、患者健康技术和行政信息技术）、循证治疗、质量管理系统、连续护理或了解 PPACA 的董事会。
HRRI 的调查结果表明，成瘾治疗领域，特别是较小的组织，还有很多工作要做，为未来的环境做好准备，这个环境对信息技术的使用、有资质的劳动力、对患者护理的问责制以及综合连续护理有更高的期望。
