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迈向人群健康:利用学习行为健康系统和基于测量的护理来改善可及性、护理、结局和差异。

Toward Population Health: Using a Learning Behavioral Health System and Measurement-Based Care to Improve Access, Care, Outcomes, and Disparities.

机构信息

Cambridge Health Alliance, 1493 Cambridge St, Cambridge, MA, 02139, USA.

Columbia University and New York State Psychiatric Institute, New York, NY, 10032, USA.

出版信息

Community Ment Health J. 2022 Nov;58(8):1428-1436. doi: 10.1007/s10597-022-00957-3. Epub 2022 Mar 30.

Abstract

Achieving population behavioral health is urgently needed. The mental health system struggles with enormous challenges of providing access to mental health services, improving quality and equitability of care, and ensuring good health outcomes across subpopulations. Little data exists about increasing access within highly constrained resources, staging/sequencing treatment along care pathways, or personalizing treatments. The conceptual model of the learning healthcare system offers a potential paradigm shift for addressing these challenges. In this article we present an overview of how the three constructs of population health, learning health systems, and measurement-based care are inter-related, and we provide an example of how one academic, community-based, safety net health system is approaching integrating these paradigms into its service delivery system. Implementation outcomes will be described in a subsequent publication. We close by discussing how ultimately, to meaningfully improve population behavioral health, a learning healthcare system could expand into a learning health community in order to target critical points of prevention and intervention.

摘要

实现人口的心理健康是当务之急。精神卫生系统在提供精神卫生服务、提高护理质量和公平性以及确保各亚人群获得良好健康结果方面面临着巨大的挑战。关于如何在资源高度受限的情况下增加服务的获取、在护理途径上进行阶段/序贯治疗或实现治疗个体化,几乎没有数据。学习型医疗保健系统的概念模型为解决这些挑战提供了一种潜在的范式转变。在本文中,我们介绍了人口健康、学习型医疗系统和基于测量的护理这三个结构是如何相互关联的,并提供了一个学术性、社区性、保障网医疗系统如何将这些范式整合到其服务提供系统中的示例。实施结果将在随后的一篇文章中进行描述。最后,我们讨论了为了真正改善人口的心理健康,学习型医疗系统如何扩展为学习型健康社区,以便针对预防和干预的关键点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ae/8964387/8981e70a3a51/10597_2022_957_Fig1_HTML.jpg

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