对智利社区精神卫生中心支付机制的探索性分析,使用混合基础理论
Olga Toro-Devia1, Rubén Alvarado1, Mercedes Jeria2
1Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Chile.
Medwave
|June 4, 2024
概括
智利 智利 智利 智利
科学领域:
- 医疗保健服务研究 医疗服务研究
- 心理健康政策 心理健康政策
- 卫生经济学 卫生经济学
背景情况:
- 精神病学非制度化改革往往嵌在卫生系统更广泛的金融改革中.
- 卫生系统内错误调整的财政激励措施可能会破坏新的心理健康政策.
- 智利国家心理健康计划的目标是以社区为基础的护理,但支付机制可能会带来挑战.
研究的目的:
- 调查智利社区心理健康中心 (CMHC) 的支付机制如何影响社区心理健康的实施.
- 确定CMHC支付结构如何与国家心理健康政策目标保持一致或不一致.
主要方法:
- 一个混合方法的融合研究,采用接地理论.
- 对2010-2020年行政生产数据的分析.
- 采访了25名付款者,提供者和用户专家,通过选择性编码和集成进行分析.
主要成果:
- 在CMHC中存在七种异构的支付机制,分为三种具有利率限制和公共预算的计划.
- 支付单位的变化与对用户,服务,人力资源和治理的负面影响有关.
- 确定了支持社区心理健康模式的具体治理,管理和支付单位条件.
结论:
- 多样化和不连接的支付计划阻碍了智利社区心理健康模式.
- 为了使财政激励与政策目标保持一致,需要制定明确的,互补的心理健康融资政策.
- 制定这样的政策是可行的,对于有效的社区心理健康服务提供至关重要.
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