Quality Measures for Mental Health Care: Results from a National Inventory

Hermann, Richard C.; Leff, H. Stephen; Palmer, R. Heather; Yang, Daoyong; Teller, Terri; Provost, Scott E.; Jakubiak, Carolyn; Chan, Jeff

doi:10.1177/1077558700057002s08

Cited by 47 publications

(20 citation statements)

References 15 publications

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“…A second limitation concerns the administrative indicators of quality of care, which are generally "less sensitive measures of health care processes than consumer derived indicators" (39) and often lack validation (40). For example, our criterion of three months to define early reregistration may be somewhat arbitrary.…”

Section: Discussionmentioning

confidence: 99%

Ethnic Differences and Similarities in Outpatient Treatment for Depression in the Netherlands

Fassaert¹,

Peen²,

Straten³

et al. 2010

Psychiatric Services

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There are widespread concerns about disparities in mental health treatment for ethnic minority groups. However, previous research in this area has been limited mainly to the United States and Great Britain, raising doubts about the external validity with respect to other European countries. This study addressed ethnic differences in characteristics of outpatient treatment for depression in the Netherlands. Methods: Longitudinal data (2001-2005) were extracted from a nationwide psychiatric case register. The sample consisted of 17,270 episodes of outpatient depression care. Information was available about timeliness of the initial treatment contact, treatment intensity, dropout, and early reregistration for mental health care. Data were analyzed with linear, logistic, and Cox regression analyses. Results: When analyses were controlled for illness and demographic characteristics, timeliness and treatment intensity were somewhat less favorable for Moroccan, Turkish, and other non-Western clients compared with ethnic Dutch. No significant differences were found between minority and ethnic Dutch groups in dropout and early reregistration. Some treatment characteristics were in fact more favorable for Surinamese and Antillean clients compared with ethnic Dutch. Conclusions: The data provided insufficient support for the idea that treatment characteristics are generally less favorable for clients from ethnic minority groups. This finding may be related to the promotion of culturally sensitive approaches to care in mainstream mental health services but may also indicate that the role of traditional barriers, like stigma and taboo, is smaller than is usually suggested. However, the influence of language proficiency, which is notably better among Surinamese and Dutch Antillean compared with Turkish and Moroccan clients, should not be disregarded. (Psychiatric Services 61:690-697, 2010) H He en nk k H He ei ij jn ne en n, , M M. .S Sc c. . P Pi im m C Cu ui ij jp pe er rs s, , P Ph h. .D D. . A Ar rn no ou ud d V Ve er rh ho oe ef ff f, , P Ph h. .D D. . A Aa ar rt tj ja an n B Be ee ek km ma an n

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Section: Discussionmentioning

confidence: 99%

Ethnic Differences and Similarities in Outpatient Treatment for Depression in the Netherlands

Fassaert¹,

Peen²,

Straten³

et al. 2010

Psychiatric Services

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“…Based on the literature [1, 2, 30], the following variables were identified: Access to care: 1) ER use and frequency of ER use, 2) hospitalization and length of stay, 3) number of outpatient consultations for any reason during year of study among PMI using the ERs; and 4) consultations among PMI without ER use; 5) outpatient consultations within the week preceding an ER visit for any reason; and 6) outpatient consultations for the year prior to an ER visit for MH reasons. Continuity of care : 1–2) outpatient consultations for MH reasons within a week, or month, after an ER visit, or 3–4) hospitalization under the same conditions; 5) repeat ER visits for any reason within 30 days after a first visit to ERs, or after a hospitalization; and 6) hospitalization of patients who re-visited the ERs and reasons for re-visits (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…Indicators used to assess MHS quality and impact on MH reforms include access, continuity and appropriateness of care [2, 30, 31], with ER attendance as a key indicator of health system access [32, 33]. Canadian and international studies have reported elevated rates of high (more than 4) and very high (more than 12) ER visits/year among PMI, particularly those with co-occurring MI and chronic physical illnesses or SUD [34–36], as compared with other patients [36–41].…”

Section: Introductionmentioning

confidence: 99%

Assessing quality indicators related to mental health emergency room utilization

et al. 2019

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BackgroundThis descriptive study compared 2014–15 to 2005–06 data on the quality of mental health services (MHS) in relation to emergency room (ER) use to assess the impact of the 2005 Quebec MH reform regarding access, continuity and appropriateness of care for patients with mental illnesses (PMI).MethodsData emanated from the Quebec Integrated Chronic Disease Surveillance System (Quebec/Canada). Participants (865,255 for 2014–15; 817,395 for 2005–06) were age 12 or over, with at least one MI, including substance use disorders (SUD), diagnosed during an ER visit, outpatient treatment or hospitalization. Variables included: access (ER use/frequency, hospitalization rates, outpatient consultations preceding an ER visit), care continuity (outpatient consultations following an ER visit/hospitalization, consecutive returns to the ERs), and care appropriateness (high ER use, recurrence of yearly ER visits, length of hospitalization). Frequency distributions were calculated on sex, age and geographic area for ER visits/hospitalizations in 2014–15, and between 2014 and 15 and 2005–06.ResultsPMI accounted for 12 % of the Quebec population in 2014–15 (n = 865,255), of whom 39% visited an ER for any reason. Amount and frequency of ER use and number/length of hospitalizations were almost twice as high for PMI versus patients without MI; 17% of PMI were also high/very high ER users and were frequently hospitalized. Among PMI, ER users were also frequent users of outpatient services despite a lack of follow-up appointments after ER visits or hospitalizations. Findings revealed some positive changes over time, such as decreased ER and hospitalization rates; yet overall access, continuity and appropriateness of care, as measured in this study, remained low.ConclusionsThis study demonstrated that the Quebec reform did not produce a substantial impact on ER use or substantially improved care, as hypothesized. Better access and continuity of care should be promoted to reduce the high prevalence of ER use among PMI. Quality improvement in MHS may be realized if ERs are supported by substantial and well-integrated community MH networks.

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“…Continuity of care is widely held to be beneficial for people with long‐term conditions, including SMI. It is valued by patients and providers and considered good practice in mental health and family medicine, reducing fragmentation of care and facilitating better provider‐patient relationships . Relational continuity—the longitudinal relationship between a patient and a health care practitioner (or group of practitioners)—is often the focus of efforts to improve continuity.…”

Section: Introductionmentioning

confidence: 99%

Impact of family practice continuity of care on unplanned hospital use for people with serious mental illness

Ride

Kasteridis

Gutacker

et al. 2019

Health Services Research

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Objective To investigate whether continuity of care in family practice reduces unplanned hospital use for people with serious mental illness (SMI). Data Sources Linked administrative data on family practice and hospital utilization by people with SMI in England, 2007‐2014. Study Design This observational cohort study used discrete‐time survival analysis to investigate the relationship between continuity of care in family practice and unplanned hospital use: emergency department (ED) presentations, and unplanned admissions for SMI and ambulatory care‐sensitive conditions (ACSC). The analysis distinguishes between relational continuity and management/ informational continuity (as captured by care plans) and accounts for unobserved confounding by examining deviation from long‐term averages. Data Collection/Extraction Methods Individual‐level family practice administrative data linked to hospital administrative data. Principal Findings Higher relational continuity was associated with 8‐11 percent lower risk of ED presentation and 23‐27 percent lower risk of ACSC admissions. Care plans were associated with 29 percent lower risk of ED presentation, 39 percent lower risk of SMI admissions, and 32 percent lower risk of ACSC admissions. Conclusions Family practice continuity of care can reduce unplanned hospital use for physical and mental health of people with SMI.

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Quality Measures for Mental Health Care: Results from a National Inventory

Cited by 47 publications

References 15 publications

Ethnic Differences and Similarities in Outpatient Treatment for Depression in the Netherlands

Ethnic Differences and Similarities in Outpatient Treatment for Depression in the Netherlands

Assessing quality indicators related to mental health emergency room utilization

Impact of family practice continuity of care on unplanned hospital use for people with serious mental illness

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