What should non-US behavioral health systems learn from the USA?: US behavior health services trends in the 1980s and 1990s.


:Several countries, such as the USA, inadvertently created a different behavioral health payment system from the rest of medicine through the introduction of diagnostic-related group exemptions for psychiatric care. This led to isolation in the administration and delivery of care for patients with mental health and substance abuse disorders from other medical services with significant, yet unintended, consequences. To insure an efficient and effective health-care system, it is necessary to recognize the problems introduced by segregating behavioral health from the rest of medical care. In this review, the authors assess trends in behavioral health services during the last two decades in the USA, a period in which independently managed behavioral health care has dominated administrative practices. During this time, behavioral health has been an easy target for aggressive cost cutting measures. There have been no clinically significant improvements in the number of adults receiving minimally adequate treatment or in the percentage of the population with behavior health problems receiving psychiatric care with the possible exception of depression. While decreased spending for behavioral health services has been well documented during this period, these savings are offset by costs shifted to greater medical service use with a net increase in the total cost of health care. Targeting behavioral health for reduction in health-care spending through independent management, starting with diagnostic procedure code or diagnostic-related group exemption may not be the wisest approach in addressing the increasing fiscal burden that medical care is placing on the national economy.


Kishi Y,Kathol RG,McAlpine DD,Meller WH,Richards SW




Has Abstract


2006-06-01 00:00:00














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    pub_type: 杂志文章


    authors: Shin C,Kim JK,Kim JH,Jung KH,Cho KJ,Lee CK,Lee SG

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    authors: Pradhan BK,Chakrabarti S,Nehra R,Mankotia A

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    authors: Chen YL,Hsu WY,Lai CS,Tang TC,Wang PW,Yeh YC,Huang MF,Yen CF,Chen CS

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    authors: Vuksić-Mihaljević Z,Mandić N,Bensić M,Mihaljević S

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    authors: Watanabe Y,Fukui N,Muratake T,Amagane H,Kaneko N,Nunokawa A,Someya T

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    authors: Hosaka T,Yamamoto K,Ikeda K,Taniyama F,Yanagisawa J

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    journal_title:Psychiatry and clinical neurosciences

    pub_type: 杂志文章


    authors: Randall M,Naka K,Yamamoto K,Nakamoto H,Arakaki H,Ogura C

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