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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >The complementarity of two major Australian primary mental health care initiatives.
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The complementarity of two major Australian primary mental health care initiatives.

机译：澳大利亚两项主要的初级精神卫生保健措施的互补性。

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OBJECTIVE: Two pivotal Australian Government primary mental health reforms are the Access to Allied Psychological Services (ATAPS) projects, introduced in July 2001 and implemented by Divisions of General Practice, and the Better Access to Psychiatrists, Psychologists and GPs through the Medicare Benefits Schedule (Better Access) programme, introduced in November 2006. This research explores the reciprocal impact of the uptake of psychological treatment delivered by these two initiatives and the impact of location (rurality and socioeconomic profile) on the uptake of both programmes since the inception of the Better Access programme. ATAPS session delivery, before and after the introduction of the Better Access program, is also examined. METHOD: General Practice Division-level data sources included a minimum dataset containing uptake data of ATAPS services, Medicare Benefits Schedule uptake data supplied by the Medicare Benefits Branch of the Department of Health and Ageing, a Rural, Remote and Metropolitan Area classification, and Indices for Relative Socio Economic Disadvantage (IRSD). Regression analyses were conducted to examine the reciprocal impact of the two programmes and the impact of rurality and socioeconomic status up to December 2008. RESULTS: A dramatic uptake of Better Access sessions, particularly in urban areas, coincided with a temporary reduction in sessions provided under ATAPS, with an overall small positive relationship detected between the two programmes. A greater proportion of ATAPS sessions (45%) have been delivered in rural areas compared with Better Access (18%). The combination of socioeconomic profile, rurality, and Better Access sessions accounted for a small but significant percentage of variance (7%) in the number of ATAPS sessions delivered, with a non-significant independent contribution of Better Access sessions to the prediction of ATAPS sessions. Weak but significant relationships between ATAPS sessions and each of socioeconomic profile (r = 0.22) and rurality (r = -0.24), respectively, were identified. In comparison, socioeconomic profile, rurality, and ATAPS sessions accounted for a much larger and significant percentage of variance (46%) in number of Better Access sessions delivered, with a non-significant independent contribution of ATAPS sessions to the prediction of Better Access sessions. Moderate significant relationships between Better Access sessions and each of socioeconomic profile (r = 0.46) and rurality (r = -0.66), respectively, were identified. The introduction of Better Access appears to have halted the steady increase in the number of ATAPS sessions previously observed. This finding should be interpreted alongside the fact that ATAPS funding is capped. CONCLUSIONS: The findings are policy relevant. ATAPS projects have been successfully providing equity of geographic and socioeconomic access for consumers most in need of subsidized psychological treatment. The uptake of psychological treatment under Better Access has been dramatic, suggesting that the programme is addressing an unmet need.
机译：目标：澳大利亚政府进行的两项关键性的基本精神卫生改革是2001年7月推出并由普通科实施的获得专职心理服务（ATAPS）项目，以及通过《医疗保险福利计划》（Medicare Benefits Schedule）更好地获得精神病医生，心理学家和全科医生的权利（于2006年11月推出的“更好的访问”计划。这项研究探讨了这两项举措所带来的采用心理治疗的相互影响，以及自更好计划推出以来地理位置（农村和社会经济状况）对这两项计划的影响访问程序。在引入更好访问程序之前和之后，还将检查ATAPS会话的传递。方法：全科部门级数据源包括一个最小数据集，其中包含ATAPS服务的摄取数据，由卫生和老龄部的Medicare福利部门提供的Medicare福利计划摄取数据，农村，偏远和大都市地区的分类以及指数相对社会经济劣势（IRSD）。进行了回归分析，以检验这两个计划的相互影响以及到2008年12月的农村和社会经济地位的影响。结果：大量采用“更好的获取”课程，特别是在城市地区，同时暂时减少了根据ATAPS，在两个计划之间发现总体上小的积极关系。与“更好的访问”（18％）相比，农村地区提供了更大比例的ATAPS会议（45％）。社会经济概况，农村地区和更好的访问会议的组合占所交付的ATAPS会议数量的很小但很大的差异（7％），而更好的访问会议对ATAPS会议的预测没有显着的独立贡献。分别确定了ATAPS会议与社会经济状况（r = 0.22）和乡村（r = -0.24）之间的弱但重要的关系。相比之下，社会经济概况，农村地区和ATAPS会议在交付的“更好的获取”会话数量中所占比例差异很大（46％），而ATAPS会话对“更好获取”会话的预测没有显着的独立贡献。分别确定了更好的获取时间与社会经济状况（r = 0.46）和乡村（r = -0.66）之间的中等显着关系。引入“更好的访问”似乎已经阻止了先前观察到的ATAPS会话数量的稳定增长。应该结合ATAPS资金上限这一事实来解释这一发现。结论：研究结果与政策有关。 ATAPS项目已经成功地为最需要补贴心理治疗的消费者提供了地理和社会经济机会的公平性。在“更好的访问权”下，对心理治疗的接受程度很高，表明该计划正在解决未满足的需求。

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