Smith G R, Waxman H, Snyder D, Raphael M
Department of Psychiatry, University of Arkansas, Little Rock, USA.
Am J Med Qual. 1996 Spring;11(1):S46-9.
With the advent of managed care, administrators of mental health care will need to implement outcomes measurement systems that will provide information for cost control and quality improvement. These systems must take into account the changes occurring in the delivery of mental health care, such as the broad range of settings in which mental health care occurs, and allow for the measurement of outcomes over time. A useful system must also be flexible, allowing measures to tailor the system to individual needs. Two types of systems are currently being used. Simple systems measure general outcomes, such as patient satisfaction, at baseline and discharge. More complex systems are disorder-specific and can be used to compare different types of treatments or different groups of patients. The simple systems are less costly but are not as useful to quality improvement. The disorder-specific systems are more expensive, but the information gathered with these systems can be used in quality management. As implementation of these systems becomes more commonplace, challenges such as lack of standardization, patient reluctance to fill out forms, and the need for sensitive measurement instruments will need to be addressed.
随着管理式医疗的出现，精神卫生保健管理人员将需要实施结果测量系统，以便为成本控制和质量改进提供信息。这些系统必须考虑到精神卫生保健服务提供过程中发生的变化，比如精神卫生保健发生的广泛环境，并允许对一段时间内的结果进行测量。一个有用的系统还必须灵活，允许根据个人需求调整测量方法。目前正在使用两种类型的系统。简单系统在基线和出院时测量一般结果，如患者满意度。更复杂的系统是针对特定疾病的，可用于比较不同类型的治疗方法或不同患者群体。简单系统成本较低，但对质量改进的作用不大。针对特定疾病的系统成本更高，但通过这些系统收集的信息可用于质量管理。随着这些系统的实施变得越来越普遍，诸如缺乏标准化、患者不愿填写表格以及需要敏感的测量工具等挑战将需要得到解决。
