Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 371
Appendix H
Levels of Care
Level A
Experience of the patient (e.g., evidence-based treatments, patient-centered
approaches, patient-provider relationship [therapeutic alliance, treatment environment])
environment])
Level B
Functioning of small units of care delivery, referred to as “microsystems” (e.g., intensive
outpatient [IOP] unit, outpatient clinic, inpatient unit)
Level C
Functioning of organizations that house or support microsystems, referred to as the
“macrosystem” (e.g., comprehensive care delivery systems, large multiple-site hospital
systems, health plans, managed care organizations [MCOs], managed behavioral
health care organizations [MBHOs])
Level D
Environment of policy, payment, regulation, accreditation and other factors that influence the
organization at Level C (e.g., federal policies, state policies, health care benefit structure,
National Committee for Quality Assurance [NCQA], Utilization Review Accreditation
Commission [URAC], health plan policies, subspecialty/trade organizations)
FIGURE H-1 Components of health care delivery systems.
SOURCE: Adapted from Berwick, 2002.
Figure H-1 depicts how the health care environment (i.e., policies,
regulation, financing [Level D]), the organizational setting (i.e., health plans
371
OCR for page 372
372 SUBSTANCE USE DISORDERS IN THE U.S. ARMED FORCES
and health systems [Level C]), and the delivery of care (i.e., clinics [Level
B]) combine to affect patient care (i.e., the patient experience [Level A]).
The committee suggests that these four levels of care provide a blueprint
applicable to the development of a 21st-century system of substance use
disorder (SUD) prevention and treatment services within the U.S. military.
REFERENCE
Berwick, D. M. 2002. A user’s manual for the IOM’s “quality chasm” report. Health Affairs
21(3):80-90.
