The CHAMPUS reform initiative in Hawaii: reestablishing a medical monopoly.
This study examined the effect of the Civilian Health and Medical Plan of the Uniformed Services (CHAMPUS) Reform Initiative (CRI) in Hawaii.
Data are presented from 1986-1991 on the professions involved, outpatient and inpatient services rendered, and psychotherapy fees by profession.
This « medical gatekeeper » model of managed care, based on a system of referral to specialist services by primary care physicians and developed by a Hawaii medical group, yielded predictable results.
Whereas psychologists had been the dominant providers of outpatient mental health services since 1980 and had a minor presence in inpatient services, the implementation of CRI resulted in psychiatrists becoming the dominant outpatient provider and psychologists essentially being eliminated from hospital practice.
Mots-clés Pascal : Santé mentale, Système santé, Service santé, Psychothérapie, Psychologue clinicien, Psychiatre, Economie santé, Politique sanitaire, Hawaï, Polynésie, Océanie, Etude critique, Etude longitudinale, Homme, Suivi cas
Mots-clés Pascal anglais : Mental health, Health system, Health service, Psychotherapy, Clinicien psychologist, Psychiatrist, Health economy, Health policy, Hawaii, Polynesia, Oceania, Critical study, Follow up study, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 94-0442299
Code Inist : 002B18H05B. Création : 199406.