Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-25T12:58:28.571Z Has data issue: false hasContentIssue false
  • English
  • Français

Analysis of patterns of mental health care with three different approaches (cross-sectional, longitudinal and dynamic)

Published online by Cambridge University Press:  11 October 2011

B. Moreno Küstner ,
F. Torres González  and
J.D. Luna Del Castillo
B. Moreno Küstner*
Affiliation:
Department of Psychiatry, School of Medicine, University of Granada. 18071 Granada (Spain)
F. Torres González
Affiliation:
Department of Psychiatry, School of Medicine, University of Granada. 18071 Granada (Spain)
J.D. Luna Del Castillo
Affiliation:
Department of Biostatistics, School of Medicine, University of Granada, 18071 Granada (Spain)
*
Indirizzo per la corrispondenza: Dra. Berta Moreno Küstner, Department of Psychiatry, School of Medicine, Avda de Madrid, 11, 18071 Granada (Spain). Fax: +34-958-275214 Telephone: 958-023130 E-mail: bmoreno@hsc.sas.cica.es
Get access Rights & Permissions [Opens in a new window]

Summary

Objective – This article attempts to provide an overview of different methods of analysis of information on service utilization from different approaches. Methods – A systematic review of the studies of pattern of care is done. The analysis of pattern of care has been divided into three different approaches: cross-sectional, longitudinal and dynamic. Results – In cross-sectional studies, information on utilization is based on the total number of contacts with mental health services during a given period. In the second approach, called longitudinal, survival analysis is applied considering the interval of time between each contact. The third type of analysis, called here the «dynamic» approach, involves the application of mathematical models based on the Markov chain to analyse the probability of change from one type of contact to another. Conclusions – We emphasise the need for further studies designed to analyse data from psychiatric case registers with standardised models for mental health services utilization analysis.

Riassunto

Scopo – Questo articolo si propone di fornire una panoramica dei diversi metodi di analisi delle informazioni relative alFutilizzazione dei servizi secondo approcci differenti. Metodi – E' stata predisposta un review sistematica degli studi sui pattern di cura. L'analisi sui pattern di cura è stata divisa secondo tre differenti approcci: cross-sectional, longitudinale e dinamico. Risultati – Negli studi cross-sectional, le informazioni sull'utilizzazione sono basate sui numero totale dei contatti con i servizi di salute mentale, in un certo periodo. Nel secondo approccio, chiamato longitudinale, l'analisi di sopravvivenza è applicata considerando l'intervallo di tempo tra ciascun contatto. Il terzo tipo di contatto, chiamato qui approccio «dinamico», comporta l'applicazione di modelli matematici basati sulle catene markoviane per analizzare la probabilità di cambiamento da un tipo di contatto all'altro. Conclusioni – Si sottolinea la necessita di studi ulteriori predisposti per analizzare i dati dei registri psichiatrici dei casi con modelli standardizzati per l'analisi dell'utilizzazione dei servizi psichiatrici.

Keywords

servizi di salute mentaleutilizzazione dei serviziservizi mentali territorialimetodologiamental health servicesservice utilizationcommunity mental health servicesmethodology
Type
Invited paper
Information
Epidemiology and Psychiatric Sciences , Volume 10 , Issue 2 , June 2001 , pp. 82 - 89
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Amaddeo, F., Beechan, J., Bonizzato, J., Fenyo, A., Knapp, M. & Tansella, M. (1997). The use of a case register to evaluate the costs of psychiatric care. Acta Psychiatrica Scandinavica 95, 189–198.CrossRefGoogle ScholarPubMed
Amaddeo, F., Beechan, J., Bonizzato, J., Fenyo, A., Tansella, M. & Knapp, M. (1998). The cost of community-based psychiatric care for first-ever patients. A case register study. Psychological Medicine, 28, 173–183.Google ScholarPubMed
Bachrach, L.L. (1996). Deinstitutionalisation: promises, problems and prospects. In Mental Health Services Evaluation (ed. Knudsen, H.C. and Thornicroft, G.), pp 3–18Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Bloom, B. (1970). Prediction and monitoring of resource utilization in a community oriented mental hospital. American Journal of Public Health 60, 2257–2268.CrossRefGoogle Scholar
Coleman, J.S. (1981). Longitudinal Data Analysis. Basic Books: New York.Google Scholar
de Jong, A. (1996). International Classification of Mental Health Care. Department of Social Psychiatry, University of Groningen: Groningen.Google Scholar
Eaton, W.W., Mortensen, P.B., Herrman, H., Bilker, W., Burgess, P. & Wooff, K. (1992a). Long-term course of hospitalization for schizophrenia: Part 1. Risk for rehospitalization. Schizophrenia Bulletin 18, 217–228.CrossRefGoogle Scholar
Eaton, W.W., Bilker, W., Haro, J.M., Herman, H., Mortensen, P.B., Freeman, H.L. & Burguess, P. (1992b). Long-term course of hospitalization for schizophrenia, Part 2. Change with passage of time. Schizophrenia Bulletin 18, 217–228.CrossRefGoogle ScholarPubMed
Faccincani, C, Mignolli, C. & Platt, S. (1990). Service utilisation, social support and psychiatric status in a cohort of patients with schizophrenic psychoses. A 7 year follow-up study. Schizophrenia Research 3, 139–146.CrossRefGoogle Scholar
Foster, R.H. & Goa, K.L. (1999). Olanzapine: A phramacoeconomic review of its use in schizophrenia. Pharmacoeconomics 15, 611–640.CrossRefGoogle ScholarPubMed
Gater, R., Amaddeo, F., Tansella, M., Jackson, G. & Goldberg, D. (1995). A comparison of community-based care for schizophrenia in South Verona and South Manchester. British Journal of Psychiatry 166, 344–352.CrossRefGoogle ScholarPubMed
Giel, R. & Sytema, S. (1993). Patterns of care in psychiatric caseregister areas. Epidemiologia e Psichiatria Sociale 2, 79–82.CrossRefGoogle Scholar
Giel, R., Horn, G.H.M.M.Ten, , Hermann, P. & Tricot, L. (1987). Patterns of care and service utilization. In Mental Health Services in Pilot Study Areas: Report on a European Study, (ed. World Health Organization), pp. 77–117. WHO: Copenhagen.Google Scholar
Häfner, H. & an der Heiden, W. (1983). The impact of a changing system of care on patterns of utilization by schizophrenics. Social Psychiatry 18, 153–166.CrossRefGoogle ScholarPubMed
Häfner, H. & an der Heiden, W. (1989). The evaluation of mental health care systems. British Journal of Psychiatry 155, 12–17.CrossRefGoogle ScholarPubMed
Hansson, L. & Sandlund, M. (1992). Utilization and patterns of care in comprehensive psychiatric care organizations. Acta Psychiatrica Scandinavica 86, 255–261.CrossRefGoogle ScholarPubMed
Hargreaves, W.A. (1986). Theory of psychiatric treatment systems. Archives of General Psychiatry 43, 701–705.CrossRefGoogle ScholarPubMed
Haro, J.L., Salvador-Carulla, L., Cabases, J.M., Madoz, V. & Vazquez, Barquero J.L. (1998). Utilisation of mental health services and costs of patients with schizophrenia in three areas of Spain. British Journal of Psychiatry 173, 334–340.CrossRefGoogle ScholarPubMed
Henisz, J.E., Flynn, H.R. & Levine, M. (1977). Clients and patients of mental health services. Archives of General Psychiatry 34, 1345–1348.CrossRefGoogle ScholarPubMed
Jonhson, S., Prosser, D., Bindman, J. & Szmukler, G. (1997). Continuity of care for the severely mentally ill: concepts and measures. Social Psychiatry and Psychiatry Epidemiology 32, 137–142.CrossRefGoogle Scholar
Launois, R., Von der Schulenburg, M.G., Knapp, M. & Toumi, M. (1998). Cost-effectiveness of sertindole versus olanzapine or haloperidol: a comprehensive model. International Journal of Psychiatry Clinical Practice 2, 79–86.Google Scholar
Lavik, N.J. (1983). Utilization of mental health services over a given period. Acta Psychiatrica Scandinavica 67, 404–413.CrossRefGoogle Scholar
Lavik, N.J. (1987). The relationship between social conditions, service models and patterns of care. In Mental Health Services in Pilot Study Areas. Report on a European Study (ed. World Health Organization), pp 123–145. WHO: Copenhagen.Google Scholar
Manderscheid, R.W. (2000). The measurement and management of clinical outcomes in mental health. American Journal of Psychiatry 157, 1903–1904.CrossRefGoogle Scholar
Medianos, M., Zacharakis, C. & Tsitsa, C. (2000). Utilization of psychiatric inpatient care in Greece: a nationwide study (1984-1996). International Journal of Social Psychiatry 46, 89–100.CrossRefGoogle Scholar
Meredith, J. (1976). Program evaluation techniques in the health services. American Journal of Public Health 66, 1069–1078.CrossRefGoogle ScholarPubMed
Moreno, Küstner B., Luna del Castillo, J., Torres-González, F. (1999). The Andalusian case register for schizophrenia. An attempt to obtain patterns of use of mental health services for planning medical care. In Manage or Perish? The Challenges of Managed Mental Health Care in Europe (ed. Guimon, J. and Sartorius, N.), pp. 573–583. Kluwer Academic/Plenum Publishers: New York.CrossRefGoogle ScholarPubMed
Moreno-Küstner, B., Rosales-Varo, C, Torres-González, F. (in press). The goals and method of the andalusian case register for schizophrenia. International Journal of Social Psychiatry.Google Scholar
Mortensen, P.B. & Eaton, W.W. (1994). Predictors for readmission risk in schizophrenia. Psychological Medicine 24, 223–232.CrossRefGoogle ScholarPubMed
Oiesvold, T., Saarento, O., Sytema, S., Christiansen, L., Gostas, G., Lonnerberg, O., Muus, S., Sandlund, M. & Hansson, L. (1999). The Nordic Comparative Study on Sectorized Psychiatry – length of inpatient stay. Acta Psychiatrica Scandinavica, 100, 220–228.CrossRefGoogle Scholar
Oldehinkel, T. (1997). Trends and Transitions in Fifteen Years of Psychiatric Care Utilization. (Thesis) Ponsen and Looijen BV: Wageningen.Google Scholar
Perry, J., Lavori, H.A. & Hoke, L. (1987). Markov model predicting levels of psychiatric service use in borderline analysis. Journal of Psychiatry Research 21, 215–232.CrossRefGoogle Scholar
Sweillam, T. & Tardiff, K. (1978). Prediction of psychiatric in patient utilization. A Markov chain model. Administration of Mental Health 6, 161–173.CrossRefGoogle Scholar
Sytema, S. (1994). Patterns of Mental Health Care. Methods and International Comparative research (Thesis). State University of Groningen: Groningen.Google Scholar
Sytema, S. (1997). Service utilization research: goals and prospects. In Making Rational Mental Health Services (ed. Tansella, M.), pp. 127–136. Il Pensiero Scientifico Editore: Roma.Google Scholar
Sytema, S. & Burgess, P. (1999). Continuity of care and readmission in two service systems: a comparative Victorian and Groningen caseregister study. Acta Psychiatrica Scandinavica 100, 212–219.CrossRefGoogle ScholarPubMed
Sytema, S. & Oldehinkel, T. (1996). Dynamic analysis of patterns of care. In Mental Health Service Evaluation (ed. Knudsen, H.C. and Thornicroft, G.), pp.213–227. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Sytema, S., Giel, R. & ten Horn, G.H.M.M. (1989a). Patterns of care in the field of mental health. Acta Psychiatrica Scandinavica 79, 1–10.CrossRefGoogle ScholarPubMed
Sytema, S., Giel, R., ten Horn, G.H.M.M. & Tansella, M. (1989b). Use of mental health services in South-Verona and Groningen. Acta Psychiatrica Scandinavica 79, 153–162.CrossRefGoogle ScholarPubMed
Sytema, S., Micciolo, R. & Tansella, M. (1996). Service utilization of schizophrenic patients in Groningen and South-Verona: An event history analysis. Psychological Medicine 26, 109–119.CrossRefGoogle ScholarPubMed
Sytema, S., Micciolo, R. & Tansella, M. (1997). Continuity of care for patients with schizophrenia and related disorders; a comparative South-Verona and Groningen case register study. Psychological Medicine 27, 1355–1362.CrossRefGoogle ScholarPubMed
Tansella, M. (2000). Do we still need psychiatry case registers? Acta Psychiatrica Scandinavica 101, 253–255.CrossRefGoogle Scholar
Tansella, M., Micciolo, R. & Balestrieri, M. (1986). High and long-term users of the mental health services. A case register study in Italy. Social Psychiatry 21, 96–103.CrossRefGoogle ScholarPubMed
Tansella, M., Micciolo, R., Biggeri, A., Bisoffi, G. & Balestrieri, M. (1995). Episodes of care in first-ever psychiatric patients. A longterm case-register evaluation in a mainly urban area. British Journal of Psychiatry 167, 220–227.CrossRefGoogle Scholar
ten Horn, G.H.M.M., Moschel, G., Giel, R. & Häfner, H. (1988). Patterns of care in two European areas: Manheim, FRD and Groningen (Holland). Acta Psychiatrica Scandinavica 77, 271–279.CrossRefGoogle Scholar
Thornicroft, G. & Tansella, M. (1999). The Mental Health Matrix. A Manual to Improve Services. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Tricot, L. (1989). Un ejemplo de estandarización de la terminología: definiendo los episodios de asistencia. In Registro de Casos Psiquidtricos en Salud Publica: Un inventario mundial 1960–1985 (ed. Horn, G.H.M.M. ten, Giel, R., Gulbinat, W.H. and Henderson, J.H.), pp 190–195. Servicio Galego de Saúde: Santiago de Compostela (Originally published as: Psychiatric Case Registers in Public Health. A Worldwide Inventory. Elsevier: Amsterdam, 1986).Google Scholar
Tuma, N.B. & Hannan, M.T. (1984). Social Dynamics. Models and Methods. Academic Press: New York.Google Scholar
White, D.J. (1992). Markov Decision Processes. Wiley and Son: Chischester.Google Scholar