Jones Jenna M, Ali Mir M, Mutter Ryan, Mosher Henke Rachel, Gokhale Manjusha, Marder William, Mark Tami
Truven Health Analytics, 7700 Old Georgetown Road, Bethesda, MD, 20814, USA.
Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20852, USA.
J Behav Health Serv Res. 2018 Oct;45(4):614-626. doi: 10.1007/s11414-017-9575-6.
According to the US Department of Health and Human Services, 91 million adults live in mental health professional shortage areas and 10 million individuals have serious mental illness (SMI). This study examines how the supply of psychiatrists, severity of mental illness, out-of-pocket costs, and health insurance type influence patients' decisions to receive treatment and the type of provider chosen. Analyses using 2012-2013 MarketScan Commercial Claims data showed that patients residing in an area with few psychiatrists per capita had a higher predicted probability of not receiving follow-up care (46.4%) compared with patients residing in an area with more psychiatrists per capita (42.5%), and those in low-psychiatrist-supply areas had a higher predicted probability of receiving prescription medication only (10.2 vs 7.6%). Patients with SMI were more likely than those without SMI to obtain treatment. A $25 increase in out-of-pocket costs had marginal impact on patients' treatment choices.
根据美国卫生与公众服务部的数据，9100万成年人生活在精神卫生专业人员短缺地区，1000万人患有严重精神疾病（SMI）。本研究考察了精神科医生的供应情况、精神疾病的严重程度、自付费用以及医疗保险类型如何影响患者接受治疗的决定和所选择的医疗服务提供者类型。使用2012 - 2013年市场扫描商业索赔数据进行的分析表明，与居住在人均精神科医生较多地区的患者（42.5%）相比，居住在人均精神科医生较少地区的患者未接受后续护理的预测概率更高（46.4%），且精神科医生供应低的地区患者仅接受处方药治疗的预测概率更高（分别为10.2%和7.6%）。患有严重精神疾病的患者比未患严重精神疾病的患者更有可能接受治疗。自付费用增加25美元对患者的治疗选择产生了边际影响。
