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2
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J Gen Intern Med. 2020 Dec;35(12):3745-3746. doi: 10.1007/s11606-019-05579-2. Epub 2019 Dec 16.
3
Bridging the Behavioral Health Gap in Serious Illness Care: Challenges and Strategies for Workforce Development.弥合严重疾病护理中的行为健康差距:劳动力发展面临的挑战与策略。
Am J Geriatr Psychiatry. 2020 Apr;28(4):448-462. doi: 10.1016/j.jagp.2019.09.003. Epub 2019 Sep 7.
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Early Health System Experiences with Collaborative Care (CoCM) Billing Codes: a Qualitative Study of Leadership and Support Staff.早期医疗体系中合作式照护(CoCM)计费代码的应用经验:对领导层和支持人员的定性研究。
J Gen Intern Med. 2019 Oct;34(10):2150-2158. doi: 10.1007/s11606-019-05195-0. Epub 2019 Jul 31.
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Can Alternative Payment Models Save Primary Care?: Lessons From Hawaii for the Nation.替代支付模式能否拯救初级医疗保健?:夏威夷给全国的经验教训。
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Natural history of histologically proven alcohol-related liver disease: A systematic review.组织学证实的酒精性肝病的自然史:系统评价。
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Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health.责任医疗组织在抑郁症治疗中的表现:对基于价值的支付和行为健康的启示。
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J Behav Health Serv Res. 2019 Oct;46(4):656-679. doi: 10.1007/s11414-019-09652-w.
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Depression in the Primary Care Setting.基层医疗中的抑郁。
N Engl J Med. 2019 Feb 7;380(6):559-568. doi: 10.1056/NEJMcp1712493.
10
Evolving Models of Integrated Behavioral Health and Primary Care.综合行为健康与初级保健的演进模式。
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将心理健康与成瘾治疗纳入普通医疗保健:政策的作用。

Integrating Mental Health and Addiction Treatment Into General Medical Care: The Role of Policy.

作者信息

McGinty Emma E, Daumit Gail L

机构信息

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health (McGinty), and Division of General Internal Medicine, Johns Hopkins School of Medicine (Daumit), Baltimore.

出版信息

Psychiatr Serv. 2020 Nov 1;71(11):1163-1169. doi: 10.1176/appi.ps.202000183. Epub 2020 Jun 3.

DOI:10.1176/appi.ps.202000183
PMID:32487007
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7606646/
Abstract

Interventions that integrate care for mental illness or substance use disorders into general medical care settings have been shown to improve patient outcomes in clinical trials, but efficacious models are complex and difficult to scale up in real-world practice settings. Existing payment policies have proven inadequate to facilitate adoption of effective integrated care models. This article provides an overview of evidence-based models of integrated care, discusses the key elements of such models, considers how existing policies have fallen short, and outlines future policy strategies. Priorities include payment policies that adequately support structural elements of integrated care and incentivize multidisciplinary team formation and accountability for patient outcomes, as well as policies to expand the specialty mental health and addiction treatment workforce and address the social determinants of health that disproportionately influence health and well-being among people with mental illness or substance use disorders.

摘要

将精神疾病或物质使用障碍的护理纳入普通医疗环境的干预措施在临床试验中已被证明能改善患者预后,但有效的模式很复杂,在现实世界的实践环境中难以扩大规模。事实证明,现有的支付政策不足以促进有效综合护理模式的采用。本文概述了循证综合护理模式,讨论了此类模式的关键要素,分析了现有政策的不足之处,并概述了未来的政策策略。优先事项包括充分支持综合护理结构要素、激励多学科团队组建以及对患者预后负责的支付政策,以及扩大专业心理健康和成瘾治疗劳动力队伍、解决对患有精神疾病或物质使用障碍的人群的健康和福祉有不成比例影响的健康社会决定因素的政策。