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Configuring Health Care for Systematic Behavioral Screening and Intervention

机译：配置卫生保健以进行系统的行为筛查和干预

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摘要

The United States Preventive Services Task Force recommends universal screening and intervention for tobacco use, excessive drinking, and depression. These services improve health outcomes, decrease health care costs, enhance public safety, and generate substantial return on investment. Given the prevalence rates of these behavioral conditions and the time necessary for evidence-based interventions, it will be challenging to integrate behavioral screening and intervention (BSI) into busy health care settings. Therefore, consistent with the principles of the medical home and the chronic care model, the health care team must be expanded to systematically provide BSI. A 2-tiered, stepped-care model is proposed. The first tier of services-consisting of assessment, intervention, and follow-up services-would address most mild-to-moderate behavioral risks or conditions. The second tier would include various specialty-based resources, which would be conserved for patients with greatest need and potential to benefit. With slight enhancement of their training, health educators would be excellent candidates to serve as cost-efficient providers of first-tier services. The proposed model would help the United States realize improved health outcomes and cost savings as health care benefits are expanded to a greater proportion of its population.
机译：美国预防服务工作队建议对烟草使用，过度饮酒和抑郁症进行普遍筛查和干预。这些服务可改善健康状况，降低医疗保健成本，增强公共安全并产生可观的投资回报。考虑到这些行为状况的患病率以及基于证据的干预措施所需的时间，将行为筛查和干预措施（BSI）集成到繁忙的医疗机构中将是一个挑战。因此，根据医疗之家和长期护理模式的原则，必须扩大医疗团队以系统地提供BSI。提出了一个2层的阶梯式护理模型。服务的第一层（包括评估，干预和后续服务）将解决大多数轻度到中度的行为风险或状况。第二层将包括各种基于专业的资源，将这些资源保留给最需要和有潜力受益的患者。通过略微提高培训水平，健康教育者将成为一流服务的高性价比提供者。提议的模型将有助于美国实现更好的健康结果并节省成本，因为医疗保健福利将扩大到其人口的更大比例。

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  • 来源
    《Population health management》 |2011年第6期|p.299-305|共7页
  • 作者

    Richard L. Brown;

  • 作者单位

    Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin;

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