Goldstein L S
Northern Virginia Psychiatric Group, Fairfax, Virginia 22031.
Gen Hosp Psychiatry. 1989 Jul;11(4):271-7. doi: 10.1016/0163-8343(89)90075-3.
As the cost of health care rises, greater emphasis is being placed on the value--or quality in relation to the cost--of mental health and substance abuse care. Health maintenance organizations, insurance companies, and other third-party payors of medical care have focused on lowering the cost of medical care by inserting benefit barriers, access barriers, treatment restrictions, case management, and other interventions into physicians' health care delivery. Possible future developments include the use of scientifically validated standards and criteria. One alternative open to psychiatrists is what the author terms genuine managed care. This approach emphasizes a practice pattern. The practice pattern suggests certain structures and processes to deliver services. A prototype group practice is outlined as a way of providing effective, high-quality care. Inpatient length of stay and outpatient length of treatment data are presented and evaluated.
随着医疗保健成本的上升，人们越来越重视精神健康和药物滥用治疗的价值——即与成本相关的质量。健康维护组织、保险公司和其他第三方医疗支付方通过在医生的医疗服务中设置福利障碍、准入障碍、治疗限制、病例管理及其他干预措施，致力于降低医疗成本。未来可能的发展包括采用经过科学验证的标准和准则。精神科医生可选择的一种方式就是作者所说的真正的管理式医疗。这种方法强调一种实践模式。该实践模式提出了提供服务的某些结构和流程。文中概述了一个原型团体医疗模式，作为提供有效、高质量护理的一种方式。还给出并评估了住院天数和门诊治疗时长的数据。
