Noll Elizabeth L, Rothbard Aileen B, Hadley Trevor R, Hurford Matthew O
The authors are with the Center for Mental Health Policy and Services Research, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (e-mail:
Psychiatr Serv. 2016 Jul 1;67(7):794-7. doi: 10.1176/appi.ps.201500060. Epub 2016 Feb 29.
In light of the national trend toward integrating mental and general medical care, this study examined disparities in diabetes treatment among Medicaid recipients in a nonintegrated, managed care behavioral health carve-out system.
A retrospective study of Medicaid claims (July 2009-June 2010) compared quality of diabetes treatment among 21,015 patients with and without mental disorders.
Presence of a mental disorder was associated with higher use of outpatient and primary care services for diabetes, lower rates of hospitalizations for diabetes, and higher odds of receiving three or more quality measures for diabetes care. Patients with serious mental illness had better diabetes care compared with patients with other mental disorders and patients with no mental disorders.
Findings suggest that managed care behavioral health carve-out systems should be considered among the range of approaches for improving treatment for diabetes among persons with comorbid mental disorders, particularly serious mental disorders.
鉴于全国精神医疗与普通医疗整合的趋势，本研究在非整合的、管理式医疗行为健康分离系统中，考察了医疗补助受助者在糖尿病治疗方面的差异。
一项对医疗补助索赔（2009年7月至2010年6月）的回顾性研究，比较了21015名有精神障碍和无精神障碍患者的糖尿病治疗质量。
患有精神障碍与糖尿病门诊和初级保健服务的更高使用率、糖尿病住院率较低以及接受三项或更多糖尿病护理质量指标的更高几率相关。与其他精神障碍患者和无精神障碍患者相比，患有严重精神疾病的患者糖尿病护理情况更好。
研究结果表明，在改善合并精神障碍尤其是严重精神障碍患者糖尿病治疗的一系列方法中，应考虑管理式医疗行为健康分离系统。
