Aguayo Patricia, Lin Anne G, Stevens Paul T, Carbone Paul S, Bilder Deborah A, Rapaport Mark H
Department of Psychiatry (Aguayo, Lin, Stevens, Bilder, Rapaport), and Department of Pediatrics (Carbone, Bilder), University of Utah, Salt Lake City.
Focus (Am Psychiatr Publ). 2024 Apr;22(2):170-174. doi: 10.1176/appi.focus.20230036. Epub 2024 Apr 10.
Innovative models of medical and psychiatric care are necessary to address the complex needs of individuals with intellectual and developmental disabilities (IDD), including autism. This article describes a subspecialty medical home program that has provided accessible, comprehensive, coordinated, patient- and family-centered care for this high-needs, underserved patient population. For more than two decades, the University of Utah Huntsman Mental Health Institute Neurobehavior HOME Program (HOME) has provided primary and behavioral health care for individuals with IDD across their lifespan. Program highlights include integrated medical and behavioral health, a unique funding structure, innovative care delivery, and case management. HOME is a clinical setting as well as a Medicaid managed care plan that has blended medical and psychiatric funding streams. This unique funding structure has demonstrated the fiscal sustainability of focusing care on preventive and proactive management of health concerns and responding to crises using a coordinated and comprehensive approach. Rethinking health care delivery and adopting models that are both financially sustainable and provide quality care to this vulnerable population is greatly needed.
创新的医疗和精神护理模式对于满足包括自闭症患者在内的智力和发育障碍（IDD）个体的复杂需求至关重要。本文介绍了一个专科医疗家庭项目，该项目为这一高需求、服务不足的患者群体提供了可及、全面、协调、以患者和家庭为中心的护理。二十多年来，犹他大学亨茨曼心理健康研究所神经行为家庭项目（HOME）为患有IDD的个体提供了贯穿其一生的初级和行为健康护理。项目亮点包括综合医疗和行为健康、独特的资金结构、创新的护理提供方式以及病例管理。HOME既是一个临床机构，也是一个融合了医疗和精神科资金流的医疗补助管理式护理计划。这种独特的资金结构已证明，将护理重点放在对健康问题的预防和积极管理上，并采用协调和全面的方法应对危机，在财政上是可持续的。迫切需要重新思考医疗服务的提供方式，并采用既在财政上可持续又能为这一弱势群体提供优质护理的模式。
