Improving the Quality of Health Care for Mental and Substance-Use Conditions
Buku ini diterbitkan tahun 2006 oleh National Academy Press, Washington DC. Adalah buku edisi Pertama.
Judul: Improving the Quality of Health Care for Mental and Substance-Use Conditions
Oleh: Committee on Crossing the Quality Chasm: Adaptation to
Mental Health and Addictive Disorders
Penerbit: National Academy Press, Washington DC.
Tahun: 2006
Jumlah Halaman: 529 hal.
Editor:
Committee on Crossing the Quality Chasm: Adaptation to
Mental Health and Addictive Disorders
Lingkup Pembahasan:
Buku ini mewakili dua perkembangan penting yang sekarang mengambil menempatkan dalam perawatan kesehatan. Salah satunya adalah meningkatnya perhatian untuk meningkatkan kualitas
pelayanan kesehatan dengan cara yang memperhitungkan preferensi dan nilai-nilai pasien bersama dengan temuan ilmiah tentang perawatan yang efektif. Kedua pengembangan penting berasal dari penelitian ilmiah yang memungkinkan kita untuk lebih memahami dan merawat kondisi mental dan substansi yang digunakan. Teknologi baru seperti sebagai neuroimaging dan genomik, misalnya, memungkinkan kita untuk mengamati otak dalam aksi dan memeriksa interaksi faktor genetik dan lingkungan di mental dan substansi digunakan penyakit. Kemajuan ini berpotensi berharga dengan lebih dari 10 persen dari populasi perawatan menerima kesehatan AS untuk kondisi mental dan substansi yang digunakan; banyak jutaan lebih yang membutuhkan tapi tidak menerima layanan tersebut; dan keluarga mereka dan teman-teman, pengusaha, guru, dan pembuat kebijakan yang mengalami efek penyakit ini di tempat tinggal pribadi mereka, di tempat kerja, di sekolah, dan di masyarakat pada umumnya. Buku ini mengemukakan hasil penelitian yang berfokus pada pemecahan masalah kesehatan merawat kondisi-beberapa mental dan substansi-penggunaan yang lebih kompleks dari yang berkaitan dengan pelayanan-kesehatan umum.
Daftar Isi:
SUMMARY 1
1 THE QUALITY CHASM IN HEALTH CARE FOR MENTAL AND SUBSTANCE-USE
CONDITIONS 29
More Than 33 Million Americans Annually Receive Care, 30
Continuing Advances in Care and Treatment Enable Recovery, 32
Poor Care Hinders Improvement and Recovery for Many, 35
Failure to Provide Effective Care Has Serious Personal and Societal Consequences, 37
A Charge to Cross the Quality Chasm, 44
Scope of the Study, 47
Organization of the Report, 47
2 A FRAMEWORK FOR IMPROVING QUALITY 56
Aims and Rules for Redesigning Health Care, 57
Distinctive Characteristics of Health Care for Mental/ Substance-Use Conditions, 59
Applying the Quality Chasm Approach to Health Care for Mental and Substance-Use
Conditions, 70
3 SUPPORTING PATIENTS’ DECISION-MAKING ABILITIES AND PREFERENCES 77
Rules to Help Achieve Patient-Centered Care, 78
How Stigma and Discrimination Impede Patient-Centered Care, 79
Evidence Counters Stereotypes of Impaired Decision Making and Dangerousness, 92
Coerced Treatment, 103
Actions to Support Patient-Centered Care, 108
4 STRENGTHENING THE EVIDENCE BASE AND QUALITY IMPROVEMENT
INFRASTRUCTURE 140
Problems in the Quality of Care, 141
Improving the Production of Evidence, 151
Improving Diagnosis and Assessment, 167
Better Dissemination of the Evidence, 169
Strengthening the Quality Measurement and Reporting Infrastructure, 180
Applying Quality Improvement Methods at the Locus of Care, 193
A Public–Private Strategy for Quality Measurement and Improvement, 195
5 COORDINATING CARE FOR BETTER MENTAL, SUBSTANCE-USE, AND GENERAL
HEALTH 210
Care Coordination and Related Practices Defined, 211
Failed Coordination of Care for Co-Occurring Conditions, 214
Numerous, Disconnected Care Delivery Arrangements, 218
Difficulties in Information Sharing, 232
Structures and Processes for Collaboration That Can Promote Coordinated Care, 233
6 ENSURING THE NATIONAL HEALTH INFORMATION INFRASTRUCTURE
BENEFITS PERSONS WITH MENTAL AND SUBSTANCE-USE CONDITIONS 259
A Strong Information Infrastructure Is Vital to Quality, 260
Activities Under Way to Build a National Health Information Infrastructure, 262
Need for Attention to Mental and Substance-Use Conditions in the NHII, 268
Information Technology Initiatives for Health Care for Mental/ Substance-Use Conditions, 270
Building the Capacity of Clinicians Treating Mental and Substance-Use Conditions to Participate
in the NHII , 276
Integrating Health Care for Mental and Substance-Use Conditions into the NHII, 279
7 INCREASING WORKFORCE CAPACITY FOR QUALITY IMPROVEMENT 286
Critical Role of the Workforce and Limitations to Its Effectiveness, 288
Greater Variation in the Workforce Treating M/SU Conditions, 288
Problems in Professional Education and Training, 294
Variation in Licensure and Credentialing Requirements, 304
Inadequate Continuing Education, 305
More Solo Practice, 309
Use of the Internet and Other Communication Technologies for Service Delivery, 310
Long History of Well-Intentioned but Short-Lived Workforce Initiatives, 312
Need for a Sustained Commitment to Bring About Change, 315
8 USING MARKETPLACE INCENTIVES TO LEVERAGE NEEDED CHANGE 325
Key Features of the Marketplace for Mental and Substance-Use Health Care, 326
Characteristics of Different Purchasing Strategies, 330
Procurement and the Consumer Role, 337
Effects of Market and Policy Structures on Quality, 339
Conclusions and Recommendations, 343
9 AN AGENDA FOR CHANGE 350
Knowledge Gaps in Treatment, Care Delivery, and Quality Improvement, 351
Strategies for Filling Knowledge Gaps, 355
Review of Actions Needed for Quality Improvement at All Levels of the Health Care System, 360
APPENDIXES
A Study Process and Committee Membership 391
B Constraints on Sharing Mental Health and Substance-Use
Treatment Information Imposed by Federal and State Medical Records Privacy Laws 405
C Mental and Substance-Use Health Services for Veterans: Experience with Performance
Evaluation in the Department of Veterans Affairs 423
INDEX 483
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