创建一个纵向法律数据集，以支持心理健康保险立法的法律流行病学研究。
Creation of a Longitudinal Legal Data Set to Support Legal Epidemiology Studies of Mental Health Insurance Legislation.
机构信息
National Center for Primary Care (Douglas, Li, Gaglioti), Department of Community Health and Preventive Medicine (Douglas), Department of Family Medicine (Gaglioti), Morehouse School of Medicine, Atlanta; Legal Consultant, Atlanta (Bent Weber); College of Law, Georgia State University, Atlanta (Bass); Department of Occupational Therapy, College of Allied Health Sciences (Benevides), Institute of Public and Preventive Health (Benevides), Department of Population Health Sciences, Health Economics and Modeling Division, Medical College of Georgia (Heboyan), Augusta University, Augusta, Georgia.
出版信息
Psychiatr Serv. 2022 Mar 1;73(3):265-270. doi: 10.1176/appi.ps.202100019. Epub 2021 Jul 29.
OBJECTIVE
This article describes policy surveillance methodology used to track changes in the comprehensiveness of state mental health insurance laws over 23 years, resulting in a data set that supports legal epidemiology studies measuring effects of these laws on mental health outcomes.
METHODS
Structured policy surveillance methods, including a coding protocol, blind coding of laws in 10% of states, and consensus meetings, were used to track changes in state laws from 1997 through 2019-2020. The legal database Westlaw was used to identify relevant statutes. The legal coding instrument included six questions across four themes: parity, mandated coverage, definitions of mental health conditions, and enforcement-compliance. Points (range 0-7) were assigned to reflect the laws' comprehensiveness and aid interpretation of changes over time.
RESULTS
The search resulted in 147 coding time periods across 51 jurisdictions (50 states, District of Columbia). Intercoder consensus rates increased from 89% to 100% in the final round of blinded duplicate coding. Since 1997, average comprehensiveness scores increased from 1.31 to 3.82. In 1997, 41% of jurisdictions had a parity law, 28% mandated coverage, 31% defined mental health conditions, and 8% required state agency enforcement. In 2019-2020, 94% of jurisdictions had a parity law, 63% mandated coverage, 75% defined mental health conditions, and 29% required state enforcement efforts.
CONCLUSIONS
Comprehensiveness of state mental health insurance laws increased from 1997 through 2019-2020. The State Mental Health Insurance Laws Dataset will enable evaluation research on effects of comprehensive legislation and cumulative impact.
目的
本文介绍了一种政策监测方法，用于跟踪 23 年来州心理健康保险法全面性的变化，从而形成了一个数据集，支持法律流行病学研究衡量这些法律对心理健康结果的影响。
方法
采用结构化政策监测方法，包括编码协议、对 10%的州法律进行盲法编码和共识会议，跟踪 1997 年至 2019-2020 年期间州法律的变化。Westlaw 法律数据库用于识别相关法规。法律编码工具包括四个主题的六个问题：平等、强制覆盖、心理健康状况的定义以及执法合规。分配点数（范围为 0-7）以反映法律的全面性并帮助解释随时间的变化。
结果
搜索结果在 51 个司法管辖区（50 个州和哥伦比亚特区）的 147 个编码时间段。在最后一轮盲法重复编码中，编码员之间的共识率从 89%增加到 100%。自 1997 年以来，平均全面性得分从 1.31 增加到 3.82。1997 年，41%的司法管辖区有平等法律，28%强制覆盖，31%定义心理健康状况，8%要求州机构执法。2019-2020 年，94%的司法管辖区有平等法律，63%强制覆盖，75%定义心理健康状况，29%要求州执法努力。
结论
州心理健康保险法的全面性从 1997 年增加到 2019-2020 年。州心理健康保险法数据集将使评估全面立法和累积影响的效果的研究成为可能。
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