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The children's health insurance program: Expanding the framework to evaluate state goals and performance

MILBANK QUARTERLY 2000年第3期78卷 403-+页

作者： Shi, LY Oliver, TR Huang, V Johns Hopkins Univ Baltimore MD 21218 USA

A comprehensive framework was devised to evaluate the state Children's Health Insurance Program (SCHIP) established in 1997. The framework relies on a number of potential measures and data sources for reviewing the program information recorded by states in SCHIP applications, particularly their strategic objectives and proposed performance measures. The analysis reveals that the states propose a wide range of objectives and measures and that there is considerable variation among the states: Overall, states' SCHIP plans tend to stress program enrollment and access to services but fail to emphasize the type and quality of services children receive once they are enrolled in the program. A broader conceptual framework is needed for policy makers, advocates, and researchers to make a full assessment of state goals and SCHIP performance.

关键词：儿童保健服务/组织和管理儿童保健服务/标准卫生计划实施卫生政策卫生服务易得程度方案评价/方法社会保障/组织和管理社会保障/标准州卫生计划/组织和管理州卫生计划/标准全面质量管理美国儿童人类

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State efforts to ensure hospital quality highlighted

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2000年第7期57卷 637-638页

作者： [Anonymous]

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State contracting initiatives for quality improvement in asthma care.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1998年第4期20卷 4-10页

作者： Ellenbecker, C.H. Garcia, I. Kane, M. University of Massachusetts Boston United States

This article examines the role of a state Medicaid program in standardizing and implementing quality performance measures for providers. It describes the Asthma Education and Primary Care Clinician Linkages Quality Improvement Program (QIP), one aspect of the ongoing Hospital Quality Initiative in Massachusetts. In October 1996, the second year of the initiative, the Massachusetts Division of Medical Assistance requested that all contracting hospitals submit quality improvement process and outcome measures related to asthma care, including practice guidelines, patient education materials, and documentation mechanisms to facilitate patients' appropriate follow-up contact with primary care clinicians. A team of evaluators reviewed these materials to determine whether hospitals had baseline data in place for asthma QIP development. Information forums were held with three reviewers and the hospitals to discuss various programs and progress toward quality improvement in asthma care. Reviewers also worked to identify hospital programs that could be used as models and those that would benefit from assistance in meeting the state's program goals.

关键词：哮喘/治疗合同业务/组织和管理合同业务/标准疾病管理教育继续政府规划/组织和管理政府规划/标准医院管理/标准马萨诸塞 Medicaid/组织和管理 Medicaid/标准结果与过程评价(卫生保健) 初级卫生保健/组织和管理初级卫生保健/标准方案评价质量指标卫生保健州卫生计划/组织和管理州卫生计划/标准全面质量管理美国儿童人类

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Integrating mental health into the Oregon Health Plan.

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New directions for mental health services 2000年第85期2000卷 49-56页

作者： Penner, N.R. Lynch, F.L. Oregon Health Sciences University United States

Public mental health has long struggled to be accepted as a part of health care. Its interface with social services and its broad spectrum of professionals make a clear definition of public mental health's boundaries difficult, fueling policymakers' skepticism about such acceptance. The Oregon Health Plan was the result of a process that explicitly included mental health but recognized that the tools for doing so need to be carefully developed.

关键词：卫生计划实施管理医疗规划/组织和管理 Medicaid/组织和管理精神卫生服务/组织和管理模型组织管理俄勒冈州卫生计划/组织和管理美国人类

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Lessons learned.

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New directions for mental health services 2000年第85期2000卷 7-15页

作者： Goetz, R.R. McFarland, B.H. Ross, K.V. Department of Psychiatry Oregon Health Sciences University United States

Mental health care reform in the public sector remains a local proposition. Oregon has thus far been able to avoid major failures and has modest successes to report. Although the road to achieving all that was envisio... 详细信息

关键词：卫生保健改革卫生计划实施/组织和管理精神卫生服务/组织和管理俄勒冈方案评价州卫生计划/组织和管理美国人类

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Measuring change: the first two years.

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New directions for mental health services 2000年第85期2000卷 65-72页

作者： Ross, K.V. Office of Mental Health Services Mental Health and Developmental Disability Services Division State of Oregon United States

A clear measurement strategy was required to offer the mental health organizations the flexibility they sought, yet ensure accountability. Early findings show mixed results.

关键词：数据收集/方法 Medicaid/组织和管理精神卫生服务/组织和管理俄勒冈方案评价/方法卫生保健质量州卫生计划/组织和管理美国青少年成年人儿童人类

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Risk adjusting capitation: Applications in employed and disabled populations

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Health Care Management Science 2000年第2期3.0卷 101-109页

作者： Madden, Carolyn W. Mackay, Bret P. Skillman, Susan M. Ciol, Marcia Diehr, Paula K. Department of Health Services University of Washington Seattle WA 98195 United States Department of Economics University of Washington Seattle WA 98195 United States Department of Biostatistics University of Washington Seattle WA 98195 United States

Risk adjustment may be a sensible strategy to reduce selection bias because it links managed care payment directly to the costs of providing services. In this paper we compare risk adjustment models in two populations (public employees and their dependents, and publicly-insured low income individuals with disabilities) in Washington State using two statistical approaches and three health status measures. We conclude that a two-part logistic/GLM statistical model performs better in populations with large numbers of individuals who do not use health services. This model was successfully implemented in the employed population, but the managed care program for the publicly insured population was terminated before risk adjustment could be applied. The choice of the most appropriate health status measure depends on purchasers' principles and desired outcomes. © Baltzer Science Publishers BV.

关键词：按人收费/组织和管理残疾人筹资政府保健福利计划雇员/组织和管理健康状况保险选择偏倚 Logistic模型管理医疗规划/组织和管理 Medicaid/组织和管理贫困风险调节/组织和管理州卫生计划/组织和管理美国华盛顿青少年成年人老年人女(雌)性人类男(雄)性中年人

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A provider assessment of the Massachusetts Medicaid Managed Behavioral Health Program: Year four

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ADMINISTRATION AND POLICY IN MENTAL HEALTH 1998年第4期25卷 411-426页

作者： Beinecke, RH Lockhart, A Suffolk Univ Dept Publ Management Boston MA 02108 USA

A stratified, random sample of 80 providers in the Massachusetts Medicaid Managed Mental Health/Substance Abuse Program were interviewed by phone to assess their views of the program in year four. Providers continued to believe that access and quality were the same or better than a year earlier, that client severity continued to increase while length of stay decreased, that readmissions and emergency room admissions were the same as a year earlier, and that aftercare was the same or better than a year earlier. Substantial problems were reported in the integration of services, in linkages with support services, and with administration of the program.

关键词：医务工作者的态度卫生保健提供联合/组织和管理卫生服务易得程度/标准住院时间/统计学和数值数据住院时间/发展趋势管理医疗规划/组织和管理马萨诸塞 Medicaid/组织和管理精神卫生服务/组织和管理方案评价卫生保健质量问卷调查州卫生计划/组织和管理物质滥用治疗中心/组织和管理美国成年人儿童人类

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The mental health organizations.

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New directions for mental health services 2000年第85期2000卷 57-63页

作者： Ross, K.V. McFarland, B.H. Office of Mental Health Services Mental Health and Developmental Disability Services Division State of Oregon United States

The mental health organizations in the mental health phase-in were Oregon's pioneers moving into public managed care. A delicate balance between county mental health authority and private expertise was struck loca... 详细信息

关键词：健康维护组织/组织和管理卫生计划实施精神卫生服务/组织和管理模型组织管理俄勒冈组织改革州卫生计划/组织和管理物质相关性障碍/康复美国人类

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Quantitative results.

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New directions for mental health services 2000年第85期2000卷 73-81页

作者： Lynch, F.L. Center for Health Research Kaiser Permanente Oregon Portland United States

Detailed analysis of information obtained is still under way, but initial trends appear to show stable enrollment, maintenance of minimum service levels, and lower hospital utilization.

关键词：卫生服务/利用卫生服务易得程度 Medicaid/组织和管理精神卫生服务/组织和管理俄勒冈卫生保健质量州卫生计划/组织和管理美国

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