Nicholson J, Young S D, Simon L J, Fisher W H, Bateman A
Department of Psychiatry, University of Massachusetts Medical School, Worcester 01655, USA.
J Behav Health Serv Res. 1998 Aug;25(3):279-92. doi: 10.1007/BF02287467.
Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization by nearly 60%. None of the clinical need variables that contributed to hospitalization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period. Multiple forces shaping professional standards, decision making, and quality of care are described. Public sector agencies must lay the groundwork for comprehensive evaluation prior to the implementation of privatized Medicaid managed care initiatives.
来自马萨诸塞州医疗补助管理式医疗私有化前后儿童和青少年紧急心理健康筛查事件的数据，被用于调查支付方来源与处置方式之间的关系，并比较临床需求与护理处置水平之间的匹配度。在医疗补助管理式医疗时期之后，以医疗补助作为支付方使住院几率降低了近60%。在医疗补助管理式医疗时期之前导致医疗补助事件住院的临床需求变量，在医疗补助管理式医疗时期之后均无显著意义。文中描述了塑造专业标准、决策制定和护理质量的多种力量。公共部门机构必须在实施医疗补助管理式医疗私有化举措之前，为全面评估奠定基础。
