Warner R, Huxley P
Mental Health Center of Boulder County, Boulder, Colorado 80304, USA.
Psychiatr Serv. 1998 Jun;49(6):802-7. doi: 10.1176/ps.49.6.802.
To investigate the effect of a capitated funding mechanism for the psychiatric care of Medicaid recipients, a study of outcome, satisfaction, and service utilization among adults with schizophrenia and schizoaffective disorder was conducted at a Colorado agency before and after the introduction of the new funding mechanism.
Two random samples of 100 clients each were selected, one a year before capitation was introduced and one a year after. Subjects were interviewed about their quality of life, needs, and service satisfaction. Psychopathology and service utilization were also measured.
Psychopathology was lower after capitation in most dimensions. The number of subjects admitted to the hospital during a six-month period beginning a year after capitation was 57 percent lower than in the equivalent period before capitation, with no increase in the amount of outpatient treatment provided. Subjects reported improved quality of life in the domains of work, finances, and social relations. Significant changes in needs or service satisfaction were not detected.
No evidence was found that Medicaid capitation had an adverse effect on the client population after one year. Findings suggested that capitation led to an efficient use of treatment resources.
为研究人头费筹资机制对医疗补助受助者精神疾病治疗的影响，在科罗拉多州的一个机构引入新筹资机制前后，对患有精神分裂症和分裂情感性障碍的成年人的治疗结果、满意度及服务利用情况进行了一项研究。
各选取100名客户的两个随机样本，一个在引入人头费筹资机制前一年，另一个在引入后一年。就受试者的生活质量、需求及服务满意度进行了访谈。还对精神病理学及服务利用情况进行了测量。
在多数维度上，实行人头费筹资机制后精神病理学情况有所改善。在实行人头费筹资机制一年后开始的为期六个月的时间段内，住院的受试者人数比实行人头费筹资机制前的同期减少了57%，而门诊治疗量并未增加。受试者报告在工作、财务及社会关系等方面生活质量有所改善。未发现需求或服务满意度有显著变化。
未发现有证据表明实行医疗补助人头费筹资机制一年后对客户群体有不利影响。研究结果表明，人头费筹资机制能有效利用治疗资源。
