Alexander J A, Lemak C H
Department of Health Management and Policy, University of Michigan, School of Public Health, Ann Arbor 48109-2029, USA.
J Subst Abuse. 1997;9:1-14. doi: 10.1016/s0899-3289(97)90002-x.
This study examines the perceptions of unit directors' regarding the effects of managed care on outpatient treatment and operations. Specifically, we propose that perceptions vary as a function of managed care penetration, managed care complexity, and the stringency of managed care oversight procedures. Data are from a nationally representative sample survey of 236 outpatient substance abuse treatment organizations conducted in 1995. Study findings support the thesis that directors' perceptions vary systematically with specific attributes of managed care. Specifically, directors' perceptions of positive managed care effects are associated with two managed care oversight procedures: (a) managed care limits on the number of sessions provided; and (b) managed care requirements for follow-up after treatment. Directors perceptions of negative effects of managed care are significantly related to (a) managed care penetration, (b) managed care complexity; and (c) four different managed care oversight procedures. These results have implications for treatment given the rapid growth in managed behavioral care.
本研究考察了机构主任对管理式医疗对门诊治疗及运营影响的看法。具体而言，我们提出，这些看法会因管理式医疗的渗透率、管理式医疗的复杂性以及管理式医疗监督程序的严格程度而有所不同。数据来自1995年对236个门诊药物滥用治疗机构进行的一项具有全国代表性的抽样调查。研究结果支持这样一种论点，即主任们的看法会随着管理式医疗的特定属性而系统性地变化。具体来说，主任们对管理式医疗积极影响的看法与两种管理式医疗监督程序相关：（a）管理式医疗对提供治疗疗程数量的限制；以及（b）管理式医疗对治疗后随访的要求。主任们对管理式医疗负面影响的看法与以下因素显著相关：（a）管理式医疗的渗透率；（b）管理式医疗的复杂性；以及（c）四种不同的管理式医疗监督程序。鉴于管理式行为医疗的迅速发展，这些结果对治疗具有启示意义。
