Improving the Quality of Health Care for Mental and Substance-Use Conditions

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National Academies Press, Mar 29, 2006 - Medical - 528 pages
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Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousā€"for these individuals and their families; their employers and the workforce; for the nationā€™s economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceā€"use conditions will benefit from this guide to achieving better care.

 

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Contents

Summary
1
1 The Quality Chasm in Health Care for Mental and SubstanceUse Conditions
29
2 A Framework for Improving Quality
56
3 Supporting Patients DecisionMaking Abilities and Preferences
77
4 Strengthening the Evidence Base and Quality Improvement Infrastructure
140
5 Coordinating Care for Better Mental SubstanceUse and General Health
210
6 Ensuring the National Health Information Infrastructure Benefits Persons with Mental and SubstanceUse Conditions
259
7 Increasing Workforce Capacity for Quality Improvement
286
8 Using Marketplace Incentives to Leverage Needed Change
325
9 An Agenda for Change
350
Appendixes
391
Appendix B Constraints on Sharing Mental Health and SubstanceUse Treatment Information Imposed by Federal and State Medical Records Privacy ...
405
Experience with Performance Evaluation in the Department of Veterans Affairs
423
Index
483
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