Mauri Amanda I, Rouhani Saba, Purtle Jonathan
Department of Public Health Policy and Management (Mauri, Purtle), Department of Epidemiology (Rouhani), and Center for Anti-Racism, Social Justice and Public Health (Rouhani), New York University School of Global Public Health, New York City.
Psychiatr Serv. 2025 Jan 1;76(1):13-21. doi: 10.1176/appi.ps.20240152. Epub 2024 Aug 14.
The authors aimed to examine how certified community behavioral health clinics (CCBHCs) fulfill crisis service requirements and whether clinics added crisis services after becoming a CCBHC.
National survey data on CCBHC crisis services were paired with data on clinic features and the demographic and socioeconomic characteristics of the counties within a CCBHC service area. The dependent variables were whether CCBHCs provided the three categories of CCBHC crisis services (i.e., crisis call lines, mobile crisis response, and crisis stabilization) directly or through another organization and whether these services were added after becoming a CCBHC. Descriptive statistics and multivariable logistic regression analyses were performed with data about clinics and the counties they served. In total, 449 CCBHCs were surveyed in the summer of 2022, with a response rate of 56%. The final sample comprised 247 clinics.
The number of CCBHC employees per 1,000 people within a CCBHC service area was significantly and positively associated with clinics providing some crisis services directly (mobile crisis response: adjusted OR [AOR]=1.46, 95% CI=1.08-1.98; crisis stabilization services: AOR=1.60, 95% CI=1.17-2.19). Compared with clinics that did not receive a CCBHC Medicaid bundled payment, clinics that received this payment had higher odds of adding mobile crisis response (AOR=2.52, 95% CI=1.28-4.97) and crisis stabilization services (AOR=3.19, 95% CI=1.51-6.72) after becoming a CCBHC.
CCBHC initiatives, particularly CCBHC Medicaid bundled payments, may provide opportunities to increase the availability of behavioral health crisis services, but the sufficiency of this increase for meeting crisis care needs remains unknown.
作者旨在研究认证社区行为健康诊所（CCBHCs）如何满足危机服务要求，以及诊所在成为CCBHC后是否增加了危机服务。
关于CCBHC危机服务的全国调查数据与诊所特征以及CCBHC服务区内各县的人口和社会经济特征数据相结合。因变量是CCBHCs是直接还是通过另一个组织提供三类CCBHC危机服务（即危机热线、移动危机应对和危机稳定），以及这些服务是否在成为CCBHC后增加。使用有关诊所及其服务县的数据进行描述性统计和多变量逻辑回归分析。2022年夏季共对449家CCBHC进行了调查，回复率为56%。最终样本包括247家诊所。
CCBHC服务区内每1000人中CCBHC员工的数量与诊所直接提供一些危机服务（移动危机应对：调整后的比值比[AOR]=1.46，95%置信区间[CI]=1.08-1.98；危机稳定服务：AOR=1.60，95%CI=1.17-2.19）显著正相关。与未获得CCBHC医疗补助捆绑支付的诊所相比，获得该支付的诊所在成为CCBHC后增加移动危机应对（AOR=2.52，95%CI=1.28-4.97）和危机稳定服务（AOR=3.19，95%CI=1.51-6.72）的几率更高。
CCBHC计划，特别是CCBHC医疗补助捆绑支付，可能为增加行为健康危机服务的可及性提供机会，但这种增加是否足以满足危机护理需求尚不清楚。
