Clark R E, Xie H, Becker D R, Drake R E
Dartmouth Medical School, Department of Community and Family Medicine, Strasenburgh, Hanover, NH 03755-3862, USA.
J Behav Health Serv Res. 1998 Feb;25(1):22-34. doi: 10.1007/BF02287497.
Administrators, consumers, and policy makers are increasingly interested in supported employment as a way of helping persons with severe mental illness get and keep competitive jobs. However, in an atmosphere of increased expectations for performance and declining public financing, administrators want to know the costs and benefits of different approaches before they reallocate scarce treatment or rehabilitative dollars. This article discusses the net benefits of two approaches to supported employment that were compared in a randomized trial: Individual Placement and Support (IPS) and Group Skills Training (GST). The authors analyze costs and benefits from societal, government, and consumer perspectives. Although a previous analysis showed that IPS participants were significantly more likely to find work, worked more hours, and had higher earnings, net benefits of the two programs were not significantly different. The authors also discuss some of the strengths and weaknesses of cost-benefit analysis in mental health care and suggest future directions for policy and research.
管理人员、消费者和政策制定者越来越关注支持性就业，将其作为帮助重度精神疾病患者获得并保住有竞争力工作的一种方式。然而，在对绩效期望提高而公共资金减少的氛围下，管理人员希望在重新分配稀缺的治疗或康复资金之前，了解不同方法的成本和收益。本文讨论了在一项随机试验中比较的两种支持性就业方法的净收益：个体安置与支持（IPS）和团体技能培训（GST）。作者从社会、政府和消费者的角度分析了成本和收益。尽管先前的一项分析表明，IPS参与者找到工作的可能性显著更高，工作时间更长，收入也更高，但这两个项目的净收益并无显著差异。作者还讨论了心理健康护理中成本效益分析的一些优点和缺点，并提出了政策和研究的未来方向。
