Implications of a children's mental health managed care demonstration evaluation.
This article summarizes the major findings of the Fort Bragg Evaluation and considers alternative explanations for the results. The evaluation found that the continuum of care provided a high-quality system of care but was more expensive and produced no better clinical outcomes than traditional services. The possibility of implementation failure at both the systems and services levels is considered and rejected as an explanation for the results. Support for the validity of the measurement, design, and the analysis is also presented. The implications for research and policy are described.
Bickman
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Vanderbilt Institute for Public Policy Studies, Vanderbilt University, Nashville, TN 37212, USA.
D000293:Adolescent; D016497:Adolescent Health Services / Q000191:economics / Q000592:standards*; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000592:standards*; D003266:Continuity of Patient Care / Q000191:economics / Q000592:standards*; D017049:Employer Health Costs; D006077:Government Agencies; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000592:standards; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000592:standards*; D008605:Mental Health Services / Q000191:economics / Q000592:standards*; D008887:Military Medicine; D017146:Models, Organizational; D009657:North Carolina / Q000453:epidemiology; D010865:Pilot Projects; D015397:Program Evaluation; D015203:Reproducibility of Results