基于价值的支付和强烈的社区治疗的有效性,以减少精神病医院住院
Deborah A Duch1, Amy D Herschell2, Carly T Ferrone3
1Community Care Behavioral Health Organization, UPMC Insurance Services Division, 600 Grant Street, 8th Floor, Pittsburgh, PA, 15219, USA.
The journal of behavioral health services & research
|December 4, 2025
概括
一种基于价值的支付 (VBP) 模式成功地将资金从住院心理健康治疗 (IPMH) 转移到坚定的社区治疗 (ACT),降低了住院费用和长度,但没有影响获得护理的机会.
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
- 基于价值的护理模式
背景情况:
- 对于严重的精神疾病,住院患者的高利用率带来了巨大的成本.
- 现有的治疗模式往往倾向于昂贵的住院护理,而不是基于社区的替代方案.
- 需要创新的支付模式,以提高心理健康护理的效率和结果.
研究的目的:
- 评估基于价值的支付 (VBP) 模式对医疗保健利用和支出的影响.
- 为了比较通过VBP资助的强硬社区待遇 (ACT) 与传统资助的有效性.
- 评估VBP模型对住院心理健康治疗 (IPMH) 和社区服务的影响.
主要方法:
- 追溯观察性研究设计.
- 在VBP (N=2) 中与非VBP (N=17) 中的ACT提供者的比较.
- 对IPMH和ACT服务的支出和逗留时间的分析.
主要成果:
- 在VBP下的提供者表明,随着时间的推移,ACT和IPMH的平均支出都在下降.
- 参与VBP的提供者在住院心理健康治疗的时间较短.
- 对于通过VBP接受ACT的人来说,没有发现对获得护理的负面影响.
结论:
- 基于价值的支付模式可以有效地将资源从昂贵的住院心理健康服务转移到基于证据的社区治疗,如ACT.
- VBPs在降低医疗保健支出和提高严重精神疾病管理效率方面表现有前途.
- VBP模型通过优化治疗设置和行为健康的资源配置来支持护理质量.
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