Sederer L I, St Clair R L
McLean Hospital, Belmont, Mass. 02178.
Am J Psychiatry. 1989 Sep;146(9):1142-8. doi: 10.1176/ajp.146.9.1142.
Managed health care, through prepaid health delivery systems and utilization review organizations, is perhaps the greatest trend in modern health care. The authors examine the remarkable growth of managed care and outline its clinical, economic, ethical, and practical implications. They then review examples of how organized psychiatry has been involved in managed care and describe the efforts to date of the Massachusetts Psychiatric Society in this area. Managed care is here to stay. The future climate of psychiatric practice and the care available to psychiatric patients are dependent on informed and organized activities by psychiatrists and their local and national representatives.
通过预付费医疗服务体系和利用审查组织实施的管理式医疗保健，或许是现代医疗保健领域最显著的趋势。作者考察了管理式医疗保健的显著发展，并概述了其在临床、经济、伦理和实际方面的影响。然后，他们回顾了有组织的精神病学参与管理式医疗保健的实例，并描述了马萨诸塞州精神病学会迄今为止在这一领域所做的努力。管理式医疗保健已成为一种常态。精神病学实践的未来环境以及为精神病患者提供的护理，取决于精神科医生及其地方和国家代表开展的明智且有组织的活动。
