Carter A M, van Vleet M A
USAMEDDAC, CMHS, Fort Leavenworth, KS 66027, USA.
Mil Med. 1995 May;160(5):242-7.
Inpatient psychiatric costs were a significant part of the CHAMPUS bill at Bayne Jones Army Community Hospital. With implementation of Gateway to Care, a case management program was developed for intervention. In May 1993, Foundation Health Federal Services Inc. began a modified CHAMPUS Reform Initiative program providing an opportunity to retrospectively analyze two methods of managed care. Civilian hospital inpatient admissions for both programs during fiscal year (FY) 1993 were compared to corresponding periods in FY 1992. Under the case management program, admissions were reduced by 67%, occupied bed days by 74%, and costs by 76%. Under the Foundation Health Program, admissions were reduced by 13%, occupied bed days by 15%, and total costs by 42%. Both methods achieved savings over standard CHAMPUS. In spite of constraints that Foundation Health did not have, the case management program appeared to be more effective, demonstrating that a managed health care program directed by the hospital commander can significantly reduce costs.
在贝恩·琼斯陆军社区医院，住院精神科费用是军队医疗保健计划（CHAMPUS）账单的重要组成部分。随着“关怀之门”计划的实施，制定了一个病例管理计划用于干预。1993年5月，基础健康联邦服务公司启动了一个改良的CHAMPUS改革倡议计划，提供了一个回顾性分析两种管理式医疗方法的机会。将1993财年（FY）两个项目的 civilian 医院住院人数与1992财年的相应时期进行了比较。在病例管理计划下，住院人数减少了67%，占用床日减少了74%，费用减少了76%。在基础健康计划下，住院人数减少了13%，占用床日减少了15%，总成本减少了42%。两种方法都比标准的CHAMPUS节省了费用。尽管基础健康计划存在一些限制，但病例管理计划似乎更有效，表明由医院指挥官指导的管理式医疗计划可以显著降低成本。 （注：原文中“Civilian hospital”不太明确准确含义，暂保留英文未翻译）
