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Evaluation of a telepsychiatry pilot project

JOURNAL OF TELEMEDICINE AND TELECARE 1999年第1期5卷 38-46页

作者： Doze, S Simpson, J Hailey, D Jacobs, P Alberta Heritage Fdn Med Res Edmonton AB T5J 3S4 Canada Alberta Hosp Ponoka Ponoka AB Canada Crossroads Reg Hlth Author Wetaskiwin AB Canada Univ Alberta Dept Publ Hlth Sci Edmonton AB Canada

We assessed a telepsychiatry pilot project in which a psychiatric hospital was linked with mental health clinics in five general hospitals. Information was collected through questionnaires administered to patients, service providers and psychiatric consultants, and by interviews. The technology was considered easy to use by participating health-care professionals and patients, and the quality of the sound and picture was adequate. Survey data suggested acceptance and satisfaction on the part of patients, service providers and psychiatric consultants. An economic analysis indicated that at 396 consultations per year the service cost the same as providing a travelling psychiatrist (C$610 per consultation);with more consultations, telepsychiatry was cheaper. Information gathered during the evaluation suggested that the use of videoconferencing for psychiatric consultations was a viable option for an integrated, community-based mental health service.

关键词：加拿大社区精神卫生服务/经济学社区精神卫生服务/组织和管理成本及成本分析评价研究医院综合医院精神病试点项目精神病学/经济学精神病学/方法远程医学/经济学远程医学/方法人类

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Health and society in the 21st century

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AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY 2000年第5期34卷 715-718页

作者： Larkins, R Univ Melbourne Fac Med Dent & Hlth Sci Parkville Vic 3010 Australia

Presents the transcript of the College Address delivered during the Annual Congress of the Royal Australian and New Zealand College of Psychiatrists in Adelaide, South Australia on April 27, 2000. Treatment of degenerative diseases of the brain; Impact of changes in the political and economic structure on the delivery of education and health; Consequences of free markets in health care.

关键词：澳大利亚生物技术/发展趋势卫生保健提供/经济学卫生保健提供/发展趋势预测卫生政策国家卫生规划/经济学国家卫生规划/标准新西兰精神病学/经济学精神病学/标准精神病学/发展趋势社会变迁美国人类

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An evaluation of an Australian videoconferencing project for child and adolescent telepsychiatry

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JOURNAL OF TELEMEDICINE AND TELECARE 1999年第Sup1期5卷 21-23页

作者： Gelber, H Alexander, M Royal Childrens Hosp Mental Serv Melbourne Vic 3031 Australia

A user satisfaction survey of videoconferencing services for child and adolescent mental health was carried out over a two-year period in Victoria, Australia. The aims of the survey were to evaluate key utilization areas, effect on professional practice, and advantages and disadvantages of the videoconferencing service. Eighty questionnaires were sent out and 58 (73%) were returned. Consultations were reported as the most frequent use of videoconferencing equipment (62%), followed by clinical use (59%), supervision (36%), teaching (19%) and administration (14%). Fifty-seven per cent of respondents reported that videoconferencing had affected professional practice. Advantages of the services included cost savings (52%) while disadvantages included technological problems (40%). The findings show the benefits of videoconferencing for improving the delivery of mental health care in rural Australia.

关键词：成本及成本分析设备失效评价研究病人满意度精神病学/经济学精神病学/标准农村人口远程医学/经济学远程医学/标准维多利亚青少年儿童人类

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Psychiatrists' views of managed care and the future of psychiatry

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GENERAL HOSPITAL PSYCHIATRY 2000年第2期22卷 97-106页

作者： Regestein, QR Brigham & Womens Hosp Dept Med Div Psychiat Boston MA 02115 USA

Managed care aims to insure the health of a population rather than that of an individual. This paper compiles opinions of psychiatrists and others on managed care and lists ways managed cave potentially affects psychiatry. Managed cave reverses the economic incentives indemnity insurance gave doctors to prolong treatment. It encourages psychiatrists to spend less rime on empathic discussion and to tl:je move standardized, less costly treatments. Many psychiatrists feel distressed about how managed care has changed their practices. Capitation care will change it further. Current trends suggest the U.S. will use and train fewer psychiatrists. Psychiatrists will spend less time with individual patients and more tin-re planning and guiding the treatment of severely impaired patients. Many more psychiatrists will likely have unprecedented changes imposed on their careers. (C) 2000 Elsevier Science Inc.

关键词：伦理学医学管理医疗规划/经济学管理医疗规划/组织和管理管理医疗规划/发展趋势精神卫生服务/经济学精神卫生服务/立法和法学精神卫生服务/组织和管理精神病学/经济学精神病学/教育精神病学/组织和管理精神病学/标准精神病学/发展趋势舆论美国人类

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AN ECONOMETRIC-MODEL OF AN EPISODE OF MENTAL-HEALTH-CARE FOR PATIENTS WITH MILD CONDITIONS - IMPLICATIONS FOR CAREGIVER SUBSTITUTION

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SOCIO-ECONOMIC PLANNING SCIENCES 1990年第3期24卷 173-185页

作者： CROSS, JG KNESPER, DJ DEROOIJ, JP UNIV MICHIGAN DEPT PSYCHIATMENTAL HLTH RES INSTANN ARBORMI 48109

This article presents a model of the number of hours of mental health care, the concurrent improvement in the patient's condition, the probability the patient will receive medications, and the reasons for treatment termination. The variables related to these aspects of mental health care are analyzed separately for patients of psychiatrists, psychologists, and social workers. Estimates of the average length of treatment, the average price and income elasticities, and the average cost of treatment are obtained from the model. The major conclusions from this study are that psychiatrists do not have a benefit-cost advantage in the treatment of relatively mild conditions, and that consumer responsiveness to variations in price appear to be largely confined to the decision to seek treatment. These and other findings provide a basis for making tentative recommendations about personnel substitution and reimbursement policies in mental health.

关键词：费用效益分析/统计学和数值数据保险精神病精神卫生服务/经济学模型统计学结果与过程评价(卫生保健)/经济学精神病学/经济学心理疗法/经济学社会工作精神病/经济学美国

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CONSUMER INFORMATION AND PROVIDERS REPUTATIONS - AN EMPIRICAL-TEST IN THE MARKET FOR PSYCHOTHERAPY

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JOURNAL OF HEALTH ECONOMICS 1990年第3期9卷 321-333页

作者： HAASWILSON, D BRANDEIS UNIV HELLER SCHWALTHAMMA 02254

This paper estimates the price effects of provider-specific reputations measured as the percent of each provider's clients who are referred by 'informed community sources', such as other health professionals, school counselors, businesses, clergy, and attorneys. Using data on the prices of outpatient psychotherapy visits to private-practice social workers in Massachusetts, the results suggest that social workers with established reputations for high-quality care charge higher prices. In addition, the results suggest that intra- and inter-professional competition can constrain the pricing decisions of psychotherapists, and that increasing consumer information increases the effectiveness of this competition.

关键词：临床工作能力经济竞争费用医疗信息服务马萨诸塞模型统计学精神病学/经济学转诊和会诊/统计学和数值数据社会工作精神病/经济学

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Managed care and fee discounts in psychiatry: New evidence

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JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH 2000年第2期27卷 215-226页

作者： Scheffler, RM Garrett, AB Zarin, DA Pincus, HA Univ Calif Berkeley Sch Publ Hlth Berkeley CA 94720 USA Amer Psychiat Assoc Washington DC 20005 USA Univ Pittsburgh Sch Med Dept Psychiat Pittsburgh PA 15260 USA RAND Corp Santa Monica CA 90406 USA RAND Pittsburgh Hlth Program Pittsburgh PA USA

This article describes the extent of managed care and fee discounting in psychiatric practice using data on 970 randomly sampled American Psychiatric Association members from the 1996 National Survey of Psychiatric Practice. Seventy percent of psychiatrists were found to have some patients in managed behavioral health care programs. The survey data illustrate that psychiatrists' involvement in managed care spans primary practice settings and is fairly evenly distributed across regions of the United States. Nationally, psychiatrists discount fees for 35% of their patients, with significant variation by practice type and extent of involvement in managed behavioral health care. The average level of discount is 25% with little variation by practice type or extent of involvement in managed behavioral health care. There is little evidence that psychiatrists with patients in managed care have higher fee levels than psychiatrists with no patients in managed care.

关键词：费用分担/经济学费用医疗管理医疗规划/经济学管理医疗规划/统计学和数值数据精神卫生服务/经济学人群监测精神病学/经济学精神病学/发展趋势抽样研究美国人类

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PRICING AND LOCATION OF PHYSICIAN SERVICES IN MENTAL-HEALTH

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ECONOMIC INQUIRY 1985年第1期23卷 115-133页

作者： FRANK, RG JOHNS HOPKINS UNIV SCH HYG & PUBL HLTHBALTIMOREMD 21218 USA

Puzzling results of a positive association between the number of physicians per capita and the level of fees for physician services have been reported in the literature. These results may be due to misspecification of econometric models and use of data aggregated across medical specialties. It is hypothesized that the unusual results would not persist with a carefully specified econometric model for a single medical specialty. A general model of pricing and location of physician's services is applied to the market for psychiatrist's services. The results imply that the market for psychiatrist's services operates in a manner consistent with the predictions of the competitive model.

关键词：费用医疗卫生服务需求/经济学卫生服务研究/经济学模型理论专业业务专业场所精神病学/经济学美国

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Difficulties in obtaining informed consent by psychiatrists, surgeons and obstetricians gynaecologists

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HEALTH CARE ANALYSIS 1996年第1期4卷 65-71页

作者： Kent, G SHEFFIELD CTR HLTH & RELATED RES SHEFFIELDS YORKSHIREENGLAND

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A survey of psychiatric group practice administrators: What does the future hold

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Journal of Mental Health Administration 1986年第2期13卷 38-44页

作者： Coons, Robert H. East Central Missouri Community Mental Health Center in Mexico United States

Twenty Psychiatric Group Practice (PGP) Administrators were surveyed regarding their perceptions of the advantages and disadvantages of PGP's, and their opinions were sought regarding the future of such groups. Their responses are examined in this article. Many of the current factors in the healthcare environment that may influence the expansion of PGP's are detailed. The result is a prediction of a trend toward PGP's in the future. © 1986 Association of Behavioral Healthcare Management.

关键词：数据收集联合开业/发展趋势联合开业预付费/发展趋势精神病学/经济学统计数据美国

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