Quality of Inpatient Psychiatric Care at VA, Other Government, Nonprofit, and For-Profit Hospitals: A Comparison

Shields, Morgan C.; Rosenthal, Meredith B.

doi:10.1176/appi.ps.201600074

Cited by 18 publications

(23 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the Department of Veterans Affairs, quality measures are set by central leadership for implementation in over 160 medical centers. While quality of mental health care in the Department has been widely documented, regional variations in processes and outcomes of care are common [82][83][84][85][86] . Hence, while regional service directors are ultimately responsible for improving quality, the Department has launched national initiatives to improve quality of care and reduce disparities in mental health care, notably through the implementation of the Uniform Mental Health Services Handbook 87 and the deployment of mental health care managers in primary care settings to promote integrated care.…”

Section: Innovations In Mental Health Care Quality Measurement and Immentioning

confidence: 99%

Measuring and improving the quality of mental health care: a global perspective

et al. 2018

View full text Add to dashboard Cite

Mental disorders are common worldwide, yet the quality of care for these disorders has not increased to the same extent as that for physical conditions. In this paper, we present a framework for promoting quality measurement as a tool for improving quality of mental health care. We identify key barriers to this effort, including lack of standardized information technology-based data sources, limited scientific evidence for mental health quality measures, lack of provider training and support, and cultural barriers to integrating mental health care within general health environments. We describe several innovations that are underway worldwide which can mitigate these barriers. Based on these experiences, we offer several recommendations for improving quality of mental health care. Health care payers and providers will need a portfolio of validated measures of patient-centered outcomes across a spectrum of conditions. Common data elements will have to be developed and embedded within existing electronic health records and other information technology tools. Mental health outcomes will need to be assessed more routinely, and measurement-based care should become part of the overall culture of the mental health care system. Health care systems will need a valid way to stratify quality measures, in order to address potential gaps among subpopulations and identify groups in most need of quality improvement. Much more attention should be devoted to workforce training in and capacity for quality improvement. The field of mental health quality improvement is a team sport, requiring coordination across different providers, involvement of consumer advocates, and leveraging of resources and incentives from health care payers and systems.

show abstract

Section: Innovations In Mental Health Care Quality Measurement and Immentioning

confidence: 99%

Measuring and improving the quality of mental health care: a global perspective

et al. 2018

View full text Add to dashboard Cite

show abstract

“…A relatively recent analysis of TJC's precursor program to the IPFQR program found no meaningful difference in performance between for-profits and nonprofits on several measures, but governmentowned facilities were poor-performing outliers. 19 Little is known about whether these quality differences translate into differential responsiveness to public reporting.…”

Section: Ownershipmentioning

confidence: 99%

The Effect of Centers for Medicare and Medicaid’s Inpatient Psychiatric Facility Quality Reporting Program on the Use of Restraint and Seclusion

Shields

Busch

2020

Medical Care

Self Cite

View full text Add to dashboard Cite

Background: Patients in inpatient psychiatry settings are uniquely vulnerable to harm. As sources of harm, research and policy efforts have specifically focused on minimizing and eliminating restraint and seclusion. The Centers for Medicare and Medicaid's Inpatient Psychiatric Facility Quality Reporting (IPFQR) program attempts to systematically measure and reduce restraint and seclusion. We evaluated facilities' response to the IFPQR program and differences by ownership, hypothesizing that facilities reporting these measures for the first time will show a greater reduction and that ownership will moderate this effect.Methods: Using a difference-in-differences design and exploiting variation among facilities that previously reported on these measures to The Joint Commission, we examined the effect of the IPFQR public reporting program on the use and duration of restraint and seclusion from the end of 2012 through 2017.Results: There were a total of 9,705 observations of facilities among 1,841 unique facilities. Results suggest the IPFQR program reduced duration of restraint by 48.96% (95% CI, 16.69%-68.73%) and seclusion by 53.54% (95% CI, 19.71%-73.12%). There was no change in odds of zero restraint and, among for-profits only, a decrease of 36.89% (95% CI, 9.32%-56.07%) in the odds of zero seclusion.Conclusions: This is the first examination of the effect of the IFPQR program on restraint and seclusion, suggesting the program was successful in reducing their use. We did not find support for ownership moderating this effect. Additional research is needed to understand mechanisms of response and the impact of the program on non-targeted aspects of quality.

show abstract

“…As public hospitals have previously been found to have lower average performance scores on the IPFQR care coordination process measures, we hypothesized that public hospitals would have lower FUH scores. 17 We also hypothesized that hospitals with a high volume of Medicare beneficiaries discharged from their psychiatric units would have higher FUH scores due to the extensive literature surrounding the positive association between volume and quality, 18 including evidence linking health plans with high numbers of mental health claims to superior performance scores on the HEDIS FUH measures. 19 Based on the social ecological model 16 and previous studies that explored individual, hospital, and communitylevel characteristics associated with mental health follow-up, 12,13,20 we hypothesized that teaching hospitals, psychiatric hospitals, and smaller hospitals would have higher FUH scores, while hospitals located in rural communities and communities with high rates of poverty and minority residents would have lower scores.…”

Section: Objectivesmentioning

confidence: 99%

Variation of Follow-Up Rate After Psychiatric Hospitalization of Medicare Beneficiaries by Hospital Characteristics and Social Determinants of Health

Benjenk

Chen

2019

The American Journal of Geriatric Psychiatry

View full text Add to dashboard Cite

Hospitals have considerable opportunity to improve the quality of their transitional care processes and increase the percentage of Medicare patients receiving timely mental health follow-up after discharge. Policymakers should consider strengthening the incentives for hospital performance on these quality measures while working to improve the behavioral health infrastructure of minority communities.

show abstract

Quality of Inpatient Psychiatric Care at VA, Other Government, Nonprofit, and For-Profit Hospitals: A Comparison

Abstract: Lack of correlation across measures suggests either that inpatient psychiatric care quality is multidimensional or that it is unreliably assessed. Hospital ownership strongly predicted performance, and VA hospitals performed relatively poorly across most measures.

Cited by 18 publications

References 15 publications

Measuring and improving the quality of mental health care: a global perspective

Measuring and improving the quality of mental health care: a global perspective

The Effect of Centers for Medicare and Medicaid’s Inpatient Psychiatric Facility Quality Reporting Program on the Use of Restraint and Seclusion

Variation of Follow-Up Rate After Psychiatric Hospitalization of Medicare Beneficiaries by Hospital Characteristics and Social Determinants of Health

Contact Info

Product

Resources

About