ABSTRACT

It is not unusual to see research studies or published opinion pieces that claim to demonstrate that home-based interventions (HBI) are more effective than group-care (GC) programs for young people with emotional and behavioral difficulties. The claim about the comparative effectiveness of HBIs in contrast to GC programs can only be true if they serve the same population of young people by age, gender, and degree of emotional and behavioral difficulties and that the outcomes for HBIs are statistically significantly better than those for GC. There is a long-standing argument between those who think that GC programs are unnecessary in comparison to those who think a mature child welfare system will always need some GC programs, albeit for a few young people with extreme difficulties. This article explores this issue in terms of how legitimate comparisons can be made between these two forms of service and how case-mix adjustment provides an established method for doing this. The purpose is to move away from ideological posturing by advocates from either side of the argument and put the debate about these forms of service and their effectiveness onto a firmer evidence base.

摘要

对于有情绪和行为困难的年轻人，经常看到研究报告或发表的观点文章声称以家庭为基础的干预 (HBI) 比团体护理 (GC) 计划更有效。只有在按年龄、性别、情绪和行为困难程度为相同的年轻人群体服务并且 HBI 的结果在统计学上明显优于那些为 GC。与那些认为成熟的儿童福利体系总是需要一些 GC 计划的人相比，那些认为 GC 计划是不必要的人之间存在长期争论，尽管对于一些极端困难的年轻人来说。本文探讨了如何在这两种服务形式之间进行合理比较以及案例组合调整如何提供一种既定方法来实现这一点。目的是摆脱争论双方拥护者的意识形态姿态，并将关于这些服务形式及其有效性的辩论置于更坚实的证据基础上。