Data linkage between existing healthcare databases to support hospital epidemiology

Álvarez, Laura García; Aylin, Paul; Tian, Jian; King, Carlene; Catchpole, Mike; Hassall, S; Whittaker-Axon, K.; Holmes, Alison

doi:10.1016/j.jhin.2011.06.016

Cited by 28 publications

(13 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of a more comprehensive case-register could increase the validity of the costs outcome – although the widespread absence of data linkage between primary care, secondary care and hospital case-registers represents a drawback (Garcia Alvarez et al , 2011). The HoNOS instrument has been proposed for use in the mental health PbR system of the English NHS (Self et al , 2008; Lovaglio and Monzani, 2011, 2012; Speak and Muncer, 2015; Wang et al , 2015) and a future study directly comparing its utility with that of the PARADISE 24 metric in costs prediction might inform policy debates in UK and other countries.…”

Section: Discussionmentioning

confidence: 99%

Utility of functioning in predicting costs of care for patients with mood and anxiety disorders

Twomey¹,

Cieza

Baldwin

2017

International Clinical Psychopharmacology

View full text Add to dashboard Cite

Development of payment systems for mental health services has been hindered by limited evidence for the utility of diagnosis or symptoms in predicting costs of care. We investigated the utility of functioning information in predicting costs for patients with mood and anxiety disorders. This was a prospective cohort study involving 102 adult patients attending a tertiary referral specialist clinic for mood and anxiety disorders. The main outcome was total costs, calculated by applying unit costs to healthcare use data. After adjusting for covariates, a significant total costs association was yielded for functioning (eβ=1.02; 95% confidence interval: 1.01–1.03), but not depressive symptom severity or anxiety symptom severity. When we accounted for the correlations between the main independent variables by constructing an abridged functioning metric, a significant total costs association was again yielded for functioning (eβ=1.04; 95% confidence interval: 1.01–1.09), but not symptom severity. The utility of functioning in predicting costs for patients with mood and anxiety disorders was supported. Functioning information could be useful within mental health payment systems.

show abstract

Section: Discussionmentioning

confidence: 99%

Utility of functioning in predicting costs of care for patients with mood and anxiety disorders

Twomey¹,

Cieza

Baldwin

2017

International Clinical Psychopharmacology

View full text Add to dashboard Cite

show abstract

“…Our results suggest that PARADISE24 is an adequate instrument to monitor the clinical progress of people with SUDs across treatment phases. The use of the same instrument during different phases of treatment can help to bridge the existing information gap between hospital registries and outpatient health care records (García Álvarez et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Validity of the PARADISE24 questionnaire in people with substance use disorders: A measure to assess psychosocial difficulties

Cabello

Levola

et al. 2018

Drug and Alcohol Dependence

View full text Add to dashboard Cite

show abstract

“…Costs information could be collected directly from participants using measures such as the Client Services Receipt Inventory,[51] although this is less feasible in large-scale research, and the lack of data linkages between case-registers represents a further challenge. [52] A more diverse sample composition (e.g. including people with severe mental disorders, and older adults) would enable a more comprehensive assessment of the potential utility of the HoNOS in predicting costs.…”

Section: Discussionmentioning

confidence: 99%

Utility of the Health of the Nation Outcome Scales (HoNOS) in Predicting Mental Health Service Costs for Patients with Common Mental Health Problems: Historical Cohort Study

et al. 2016

View full text Add to dashboard Cite

BackgroundFew countries have made much progress in implementing transparent and efficient systems for the allocation of mental health care resources. In England there are ongoing efforts by the National Health Service (NHS) to develop mental health ‘payment by results’ (PbR). The system depends on the ability of patient ‘clusters’ derived from the Health of the Nation Outcome Scales (HoNOS) to predict costs. We therefore investigated the associations of individual HoNOS items and the Total HoNOS score at baseline with mental health service costs at one year follow-up.MethodsAn historical cohort study using secondary care patient records from the UK financial year 2012–2013. Included were 1,343 patients with ‘common mental health problems’, represented by ICD-10 disorders between F32-48. Costs were based on patient contacts with community-based and hospital-based mental health services. The costs outcome was transformed into ‘high costs’ vs ‘regular costs’ in main analyses.ResultsAfter adjustment for covariates, 11 HoNOS items were not associated with costs. The exception was ‘self-injury’ with an odds ratio of 1.41 (95% CI 1.10–2.99). Population attributable fractions (PAFs) for the contribution of HoNOS items to high costs ranged from 0.6% (physical illness) to 22.4% (self-injury). After adjustment, the Total HoNOS score was not associated with costs (OR 1.03, 95% CI 0.99–1.07). However, the PAF (33.3%) demonstrated that it might account for a modest proportion of the incidence of high costs.ConclusionsOur findings provide limited support for the utility of the self-injury item and Total HoNOS score in predicting costs. However, the absence of associations for the remaining HoNOS items indicates that current PbR clusters have minimal ability to predict costs, so potentially contributing to a misallocation of NHS resources across England. The findings may inform the development of mental health payment systems internationally, especially since the vast majority of countries have not progressed past the early stages of this development. Discrepancies between our findings with those from Australia and New Zealand point to the need for further international investigations.

show abstract

Data linkage between existing healthcare databases to support hospital epidemiology

Cited by 28 publications

References 15 publications

Utility of functioning in predicting costs of care for patients with mood and anxiety disorders

Utility of functioning in predicting costs of care for patients with mood and anxiety disorders

Validity of the PARADISE24 questionnaire in people with substance use disorders: A measure to assess psychosocial difficulties

Utility of the Health of the Nation Outcome Scales (HoNOS) in Predicting Mental Health Service Costs for Patients with Common Mental Health Problems: Historical Cohort Study

Contact Info

Product

Resources

About