マネージドケアでは,無制限のメンタルヘルスケアがどのくらい費用がかかりますか?
1RAND, Santa Monica, CA 90401, USA. Roland_Sturm@rand.org
JAMA
|November 18, 1997
まとめ
寛大なメンタルヘルス保険を備えたマネージドケアプランは,費用対効果が高い. メンタルヘルスケアの保険料の制限を撤廃すると,コストがわずかに上昇し,子どもが最も恩恵を受ける.
科学分野:
- 医療サービス 研究 医療サービス
- メンタルヘルス政策について
- マネージドケア (Managed Care) とは,管理された介護のことです.
背景:
- マネージドケアにおけるメンタルヘルスケアの費用に関する懸念は,医療制度改革に影響を与えました.
- 以前の政策議論は,実際のコストを反映していない可能性のある仮定に基づいていました.
研究 の 目的:
- マネージドケアにおけるメンタルヘルスケアのコスト,アクセス,および強度を分析する.
- これらの発見を,政策討論で使用されている仮定と比較する.
- メンタルヘルスケア対象範囲の制限を撤廃する財政的影響をシミュレートする.
主な方法:
- 24のマネージドケア・カーブアウト・プラン (1995-1996) の請求データ分析.
- 検討されたすべてのプランは,最小限の付加金で無制限のメンタルヘルス保険を提供していました.
- 介護の概率,強度,およびサービス種類および受験者による総費用の評価.
主要な成果:
- メンタルヘルスの管理介護費用は,政策討論で想定されたものより4~8倍低い.
- 専門的なメンタルヘルスケアへのアクセスの増加 (入学者の7.0%) は,手数料対サービスに比べて.
- 2万5千ドルの年限を撤廃すると,入学者1人あたりの支払い額は年間わずか1ドル増加し,子どもたちが主な受益者となる.
結論:
- 時代遅れのデータに基づく過大評価されたコストの懸念は,医療制度改革を妨げています.
- マネージドケアの下でのメンタルヘルス保険の強化による実際のコストの影響は,マイナーです.
- 現在,民間保険で普及しているマネージドケアは,費用対効果の高いメンタルヘルスケア拡大の実現可能性を示しています.
関連する概念動画
Introduction To Health Care Delivery System
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Preventive Healthcare Services
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
Specialized Care Centers and Settings-I
Specialized care settings or centers are situated in convenient locations within the community and offer care to a specific group or population. They consist of daycare facilities, mental health facilities, rural health facilities, educational institutions, industries, shelters for the homeless, and rehabilitation facilities.
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
Integrated Healthcare System
An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
Community Based Intervention
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...


