Intensive Alternative Family Treatment (IAFT®) is an enhanced therapeutic foster care program that serves children and youth at risk for entry into a more restrictive level of care. The purpose of this study was to examine the effectiveness of IAFT in reducing first entry into psychiatric residential treatment compared to usual care. We linked IAFT program data to Medicaid claims data in order to develop a quasi-experimental study design to compare outcomes for two groups (N = 1655): (a) youth referred to IAFT who received services and (b) youth referred to IAFT who did not receive IAFT services (i.e., usual care). Propensity score analysis was used to balance treatment and comparison groups on pre-referral indicators. Cox regression analysis was used to examine group differences. Findings supported a significant reduction in risk for entry to psychiatric residential treatment favoring IAFT (hazard ratio 0.72; 95% CI 0.55, 0.93). Results of this study support IAFT’s efficacy as an intensive therapeutic foster care model for delivering mental health services and viability as an alternative to residential care.

重症家庭替代治疗（IAFT®）是一项增强的寄养治疗计划，旨在为处于危险中的儿童和青少年提供更具限制性的护理服务。这项研究的目的是检验与常规护理相比，IAFT在减少首次进入精神科住院治疗中的有效性。我们将IAFT计划数据与Medicaid索赔数据相关联，以开发一个准实验研究设计来比较两组的结果（N = 1655）：（a）接受过IAFT服务的年轻人，以及（b）接受过IAFT服务的年轻人，即没有接受IAFT服务的年轻人（即常规护理）。倾向得分分析用于在转诊前指标上平衡治疗组和对照组。Cox回归分析用于检查组差异。研究结果支持采用IAFT的精神科住院治疗风险大大降低（危险比0.72； 95％CI 0.55，0.93）。这项研究的结果支持了IAFT作为强化治疗寄养模式的功效，该模式可提供精神健康服务和生存能力，以代替住宿护理。