通过混合支付激励共发生疾病诊断
Daniel Baslock1, Jennifer I Manuel2, Victoria Stanhope3
1School of Social Work, Virginia Commonwealth University, Richmond, VA, USA.
Social science & medicine (1982)
|December 3, 2025
概括
混合支付模式可以改善在心理健康和物质使用治疗中同时出现的疾病的识别. 这种综合护理方法增加了诊断率,特别是在社区环境中.
科学领域:
- 行为健康服务 研究 研究 行为健康服务
- 卫生经济学 卫生经济学
- 综合护理模式 综合护理模式
背景情况:
- 从历史上看,心理健康和药物使用治疗是分开的,这阻碍了对同时发生的疾病的治疗.
- 由混合支付策略促进的综合护理模式,对于解决复杂的患者需求至关重要.
- 本研究研究了混合支付模式对社区心理健康系统内共发生疾病的诊断的影响.
研究的目的:
- 评估混合支付策略对同时出现疾病的诊断率的影响.
- 评估混合支付模式如何影响复杂的行为健康状况的识别.
主要方法:
- 2017年1月至2019年12月期间,分析了来自19373名个人 (173889个观察) 的电子健康记录数据.
- 利用多级增长建模与二进制依赖变量用于同时发生的疾病诊断.
- 包括时间的固定效应,混合支付发起,种族,性别,年龄和付款人,服务用户和机构的随机效应.
主要成果:
- 混合支付 (资本化和服务费) 显著增加了同时出现疾病诊断的可能性.
- 认定自己是有色人种的个人接受同期诊断的几率较低,尽管这在农村环境中有所不同.
- 不集成机构的服务用户显示,接受同时发生的诊断的几率更高.
结论:
- 这项研究是首次评估混合支付模式对行为健康访问和诊断的影响.
- 混合支付模式可以为提供者提供经济激励,以识别通常在标准护理中错过的复杂诊断.
- 综合支付策略在改善同时出现疾病的识别和治疗方面表现有前途.
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