RAND Corporation, 4570 Fifth Avenue, Suite Pittsburgh, PA 15213, USA.
New York State Office of Mental Health, Capital District Psychiatric Center, 75 New Scotland Avenue, Albany, NY 12208, USA.
Gen Hosp Psychiatry. 2018 Mar-Apr;51:41-45. doi: 10.1016/j.genhosppsych.2017.12.006. Epub 2017 Dec 20.
To inform providers and policy-makers about the potential costs of providing physical health care in mental health clinics.
Cost data were collected through interviews with 22 behavioral health clinics participating in New York State Office of Mental Health's health monitoring and health physicals programs. The interview data was combined with financial reporting data provided to the state to identify per interaction costs for two levels of physical health services: health monitoring and health monitoring plus health physicals.
This study gives detailed information on the costs of clinics' health integration programs, including per interaction costs related to direct service, charting and administration, and total care coordination. Average direct costs per client interaction were 3 times higher for health physicals than for health monitoring.
Costs of integrating physical care services are not trivial to mental health clinics, and may pose a barrier to widespread adoption. Provision of limited health monitoring services is less expensive for clinics, but generates proportionally large non-clinical costs than health physicals. The relative health impact of this more limited approach is an important area for future study. Also, shifting reimbursement to include health care coordination time may improve program sustainability.
向医疗机构和决策者通报在精神健康诊所提供身体健康护理的潜在成本。
通过对 22 家参与纽约州心理健康办公室健康监测和健康体检项目的行为健康诊所的访谈收集成本数据。访谈数据与向州政府提供的财务报告数据相结合，以确定两种健康服务水平（健康监测和健康监测加健康体检）的每次交互成本。
本研究详细介绍了诊所健康整合计划的成本，包括与直接服务、图表记录和管理以及全面护理协调相关的每次交互成本。健康体检的每次客户交互的平均直接成本比健康监测高 3 倍。
对于精神健康诊所来说，整合身体护理服务的成本不容忽视，这可能成为广泛采用的障碍。提供有限的健康监测服务对诊所来说成本较低，但产生的非临床成本比例高于健康体检。这种更有限的方法的相对健康影响是未来研究的一个重要领域。此外，将报销转向包括医疗保健协调时间可能会提高计划的可持续性。
