Who leaves managed behavioral health care?

作     者：Gresenz, CR Sturm, R 

作者机构：Rand Corp Santa Monica CA 90401 USA 

出 版 物：《JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH》 (行为保健服务与研究杂志)

年 卷 期：1999年第26卷第4期

页      面：390-399页

核心收录：

学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

基　　金：NIDA NIH HHS [DA11832] Funding Source: Medline NIMH NIH HHS [MH54623, MH54147] Funding Source: Medline 

主　　题：行为疗法/经济学 行为疗法/统计学和数值数据 费用分配 保健福利计划 雇员/经济学 保健福利计划 雇员/利用 管理医疗规划/经济学 管理医疗规划/统计学和数值数据 精神障碍/经济学 精神障碍/流行病学 中止治疗的病人/统计学和数值数据 美国 青少年 成年人 老年人 人类 男(雄)性 中年人 

摘      要：The growth of managed care and the possibility of biased enrollment and disenrollment rates have raised concerns about cost shifting. This article analyzes the duration of continuous enrollment in a managed behavioral health organization among members with and without behavioral health care utilization and among members with different mental health conditions. Eleven large employers with more than 250,000 members who are enrolled in managed behavioral health plans are studied. Compared to managed care 10 years ago, the rate of disenrollment among patients with depression appears to have dropped. Moreover there appear few differences in disenrollment among users and nonusers of behavioral health services, except for employees for whom coverage is linked to job performance. However patients with substance abuse problems or severe types of disorders are significantly more likely to disenroll than patients with less severe problems.