Smith Thomas E, Appel Anita, Donahue Sheila A, Essock Susan M, Thomann-Howe Doreen, Karpati Adam, Marsik Trish, Myers Robert W, Sorbero Mark J, Stein Bradley D
Columbia University College of Physicians & Surgeons, New York, NY, USA,
Adm Policy Ment Health. 2014 Sep;41(5):588-97. doi: 10.1007/s10488-013-0497-1.
This study examined whether Medicaid claims and other administrative data could identify high-need individuals with serious mental illness in need of outreach in a large urban setting. A claims-based notification algorithm identified individuals belonging to high-need cohorts who may not be receiving needed services. Reviewers contacted providers who previously served the individuals to confirm whether they were in need of outreach. Over 10,000 individuals set a notification flag over 12-months. Disengagement was confirmed in 55 % of completed reviews, but outreach was initiated for only 30 %. Disengagement and outreach status varied by high-need cohort.
本研究调查了医疗补助计划索赔数据及其他行政数据能否识别大城市中需要外展服务的严重精神疾病高需求个体。一种基于索赔的通知算法识别出可能未获得所需服务的高需求队列中的个体。评审人员联系了之前为这些个体提供服务的提供者，以确认他们是否需要外展服务。在12个月内，超过10000人被设置了通知标记。在55%的已完成评审中确认存在脱离接触情况，但仅30%启动了外展服务。脱离接触和外展状态因高需求队列而异。
