What Explains the Diffusion of Treatments for Mental Illness?

摘要

Scientific advances have fueled both gains in health care outcomes and growth in health care costs. Health care for mental illness is no exception, with significant improvements in the treatment of schizophrenia, depression, and other common disorders during the last 20 years. As a general rule, diffusion and implementation of research-based health care proceeds slowly. Rates of dissemination and adoption of new treatments are influenced by many factors other than patient needs and scientific evidence. For example, marketing, profit motives, health care cultures, professional and guild issues, spending levels, organizational structures, financing mechanisms, and implementation difficulties all have been shown to influence diffusion. Because these factors ex- hibit great diversity across states, regions, and lo-cal agencies, it is perhaps not surprising that health care exhibits a high degree of geographic variation#