Psychiatric services for elderly people: Evaluating system performance

Harrison, Stephen; Sheldon, Trevor

doi:10.1002/gps.930090402

Cited by 3 publications

(3 citation statements)

References 70 publications

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“…This limits the control that program staff have over the interventions and the measurement of their outcomes. While the program's impact in improving overall care practices within a community and in changing the care system as a whole may be the key indicators of program success, evaluation of these diffuse and rather nebulous impacts is an even more difficult task 25 …”

Section: Discussionmentioning

confidence: 99%

MODELS OF GERIATRICS PRACTICE: A Community Development and Outreach Program in Geriatric Mental Health: Four Years' Experience

Reuben

Stoke

Kessler

et al. 1996

J American Geriatrics Society

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OBJECTIVES: To describe a geriatric mental health outreach program based on a community development model and to review 4 years of experience with this program. DESIGN: Program model and description of implementation experience.SETTINGS: A geriatric mental health outreach program of a regional psychiatric hospital, serving a primarily non-urban area, with offices in the community it serves.PARTICIPANTS: The program targets community-dwelling or institutionalized older persons with late-onset mental health problems and/or behavioral disturbances, persons with long-standing psychiatric disorders with age-related changes, and their caregivers.

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Section: Discussionmentioning

confidence: 99%

MODELS OF GERIATRICS PRACTICE: A Community Development and Outreach Program in Geriatric Mental Health: Four Years' Experience

Reuben

Stoke

Kessler

et al. 1996

J American Geriatrics Society

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“…These are well covered elsewhere, either at the general level of exposition and principle (Drummond et al, 1987). or in their application to mental health care and treatment (Knapp, 1995), or introduced and illustrated in relation to services for elderly people with psychiatric problems (Keen, 1993;Harrison and Sheldon, 1994;Knapp et al, 1995). Gray and Fenn (1993) offer the most recent UK burden-of-illness evaluation in the area of old age psychiatry.…”

Section: Researchmentioning

confidence: 99%

“…Some of these influences on outcome are endogenous to the care process, and thus within the control (immediately or in the longer term) of managers, psychiatrists, social workers or family carers. Other influences are exogenous: it is the latter group which tend to be overlooked in Donabedian's (1 980) framework (and see Harrison and Sheldon, 1994), but which can have marked, perhaps decisive, influences on outcomes and costs.…”

Section: Economic Evaluations: Frameworkmentioning

confidence: 99%

Resource scarcity chasing scarce resources: Health economics and geriatric psychiatry

Knapp

1995

Int J Geriat Psychiatry

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The effectiveness of old age psychiatry services

Draper

2000

Int. J. Geriat. Psychiatry

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The objective of this study was to review outcomes of acute service delivery in old age psychiatry. Sources of data included Medline, PsycINFO and Cochrane Collaboration databases of English language papers to 1998 on service delivery evaluation in ‘old age psychiatry’, ‘psychogeriatrics’ and ‘geriatric psychiatry’, supplemented by a manual search of references from relevant literature. All controlled trials, audits, and surveys of the outcomes of service delivery in old age psychiatry located in acute hospitals and community settings were included. Service delivery by medical, adult psychiatry and consultation/liaison services were included. With the exception of outreach services to nursing homes, long term institutional care was excluded. All data were extracted by the author. Data quality was assessed by applying an evidence hierarchy. Evaluation strategies were qualitatively reviewed. Controlled trials, audits and surveys were each found to provide important data in the evaluation of service delivery. There is better quality evidence to support the effectiveness of components of old age psychiatry services than other service types. The majority of studies indicate that old age psychiatry services have positive acute treatment outcomes, particularly with depression. There is insufficient evidence to determine which processes of care are associated with better outcomes. Pluralistic evaluations indicate that carers often have unmet needs and are not as positive about outcomes. There have been no controlled comparisons of service delivery provided by other services. In conclusion, controlled trials and audits indicate that old age psychiatry services are effective. Further pluralistic evaluations and comparisons with other services are required. Copyright © 2000 John Wiley & Sons, Ltd.

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Psychiatric services for elderly people: Evaluating system performance

Cited by 3 publications

References 70 publications

MODELS OF GERIATRICS PRACTICE: A Community Development and Outreach Program in Geriatric Mental Health: Four Years' Experience

MODELS OF GERIATRICS PRACTICE: A Community Development and Outreach Program in Geriatric Mental Health: Four Years' Experience

Resource scarcity chasing scarce resources: Health economics and geriatric psychiatry

The effectiveness of old age psychiatry services

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