Department of Psychiatry and Behavioral Sciences (Wetzler, Counts, Schwartz) and Department of Social and Family Medicine (Patel), Albert Einstein College of Medicine, New York City; National Council for Mental Wellbeing, Washington, D.C. (Holcombe).
Psychiatr Serv. 2023 Sep 1;74(9):1002-1005. doi: 10.1176/appi.ps.20220264. Epub 2023 Mar 14.
The Affordable Care Act established Medicaid health homes to provide care management and coordination for high-need individuals, including many with serious mental illness. The authors used data from the Medicaid Data Warehouse to examine health care utilization over 3 years among 10,193 individuals who enrolled in a New York State health home and had at least one outpatient mental health visit during the year prior to enrollment. Results for postenrollment year 2 indicated a 43% decrease in inpatient mental health discharges, a 38% decrease in substance use discharges, and a 7% reduction in general medical discharges, whereas mental health outpatient treatment and behavioral and nonbehavioral medication utilization increased. Further research is needed to determine the effectiveness of health home care management for individuals with serious mental illness.
平价医疗法案设立了医疗补助健康之家,为高需求人群提供医疗管理和协调服务,其中包括许多患有严重精神疾病的人群。作者利用医疗补助数据仓库中的数据,对在纽约州健康之家注册并在注册前一年内至少有一次门诊心理健康就诊的 10193 名个人进行了为期 3 年的医疗保健利用情况调查。结果表明,注册后第 2 年,精神科住院人数下降了 43%,物质使用障碍的出院人数下降了 38%,一般医疗出院人数下降了 7%,而心理健康门诊治疗和行为及非行为药物的使用增加了。需要进一步研究来确定健康之家对严重精神疾病患者的医疗管理的有效性。