Shuman C R
Department of Community Mental Health, U.S. Army Medical Department Activity, Fort Leavenworth, KS 66027-2332, USA.
Mil Med. 1996 Sep;161(9):557-61.
Munson Army Community Hospital has successfully realized substantial cost savings by instituting psychiatric managed care. The development of an external partnership with a civilian psychiatric facility is a unique aspect of the psychiatric managed care initiative and has resulted in most of the savings. We staff this partnership hospital with one-half full-time-equivalent psychiatrist. Other psychiatric managed care program elements include: (1) using CHAMPUS "recapture" funds to hire additional personnel; (2) maximizing personnel utilization by combining mental health staff from the social work and psychiatry services; (3) working closely with the community to identify local mental health needs; (4) offering additional therapeutic modalities; and (5) reducing rehospitalization rates through improved discharge planning. We reduced our financial-year first quarter costs by 76% from 1993 to 1995. We attributed much of these savings to reduced residential treatment admissions. Although the total number of outpatient visits increased, Munson's psychiatric services reduced outpatient costs by increasing clinic access. We have used the Gateway to Care program to prepare for the initiation of Tri-Care in our region.
芒森陆军社区医院通过实施精神科管理式医疗已成功实现大幅成本节约。与一家民用精神科机构建立外部合作关系是精神科管理式医疗举措的一个独特方面，并且已带来了大部分节约。我们为这家合作医院配备了相当于半职的精神科医生。精神科管理式医疗项目的其他要素包括：(1) 使用军队医疗保健计划（CHAMPUS）的“回收”资金来雇佣额外人员；(2) 通过合并社会工作和精神科服务部门的心理健康工作人员来最大化人员利用率；(3) 与社区密切合作以确定当地心理健康需求；(4) 提供更多治疗方式；以及(5) 通过改进出院计划降低再住院率。从1993年到1995年，我们将财政年度第一季度的成本降低了76%。我们将这些节约的很大一部分归因于住院治疗入院人数的减少。尽管门诊就诊总数有所增加，但芒森的精神科服务通过增加诊所就诊机会降低了门诊成本。我们已利用“关爱之门”项目为我们地区启动三军医疗保健计划（Tri-Care）做准备。
