Chandler D, Meisel J, Hu T, McGowen M, Madison K
University of California, Berkeley, USA.
Community Ment Health J. 1998 Feb;34(1):13-26. doi: 10.1023/a:1018708111400.
Hospitalization outcomes are examined in a three year random assignment controlled study of two capitated Integrated Service Agencies (ISAs) in California. Study participants were a cross-section of severely mentally ill clients. Using the flexibility of capitated funding, the urban ISA reduced inpatient length of stay and days, but not admissions. Elements of the capitated ISA model worked together to produce clinically appropriate and less costly use of inpatient services. At the rural ISA, admissions were reduced substantially during the first two years of the demonstration but not costs.
在一项针对加利福尼亚州两家按人头付费的综合服务机构(ISAs)进行的为期三年的随机分配对照研究中,对住院治疗结果进行了考察。研究参与者是患有严重精神疾病的客户群体。利用按人头付费资金的灵活性,城市ISAs缩短了住院时间和天数,但住院人数并未减少。按人头付费的ISAs模式的各个要素共同作用,实现了住院服务的临床合理使用且成本更低。在农村ISAs,在示范的头两年住院人数大幅减少,但成本并未降低。