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Development of a set of schizophrenia quality indicators for integrated care

Published online by Cambridge University Press:  11 April 2011

Stefan Weinmann*
Affiliation:
Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin (Germany)
Christiane Roick
Affiliation:
Federal Association of Local Health Funds (AOK-BV), Berlin (Germany)
Luise Martin
Affiliation:
Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin (Germany)
Stefan Willich
Affiliation:
Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin (Germany)
Thomas Becker
Affiliation:
Department of Psychiatry and Psychotherapy II, University of Ilm. Günzburg (Germany)
*
Address for correspondence: Dr. S. Weinmann, Institute for Social Medicine, Epidemiology and Health Economics, Charitè University Medicine Berlin, Luisenstr. 57 D-10117 Berlin (Germany). Fax: ++49-(0)30-450529902 E-mail: Stefan.Weinmann@charite.de

Extract

Aim – We aimed at developing a prioritized set of quality indicators for schizophrenia care to be used for continuous quality monitoring. They should be evidence-based and rely on routine data. Methods – A systematic literature search was performed to identify papers on validated quality indicators published between 1990 to April 2008 in MEDLINE, the Cochrane databases, EMBASE and PsycINFO. Databases of relevant national and international organizations were searched. Indicators were described with respect to meaningfulness, feasibility and actionability. A workshop with relevant stakeholders evaluated the measures through a structured consensus process. Results – We identified 78 indicators through literature search and selected 22 quality indicators. Furthermore, 12 structural and case-mix indicators were choosen. Only five quality indicators were rated “essential indicators” (priority 1), 14 were rated “additional first choice” (priority 2), and three were rated as “additional second choice” (priority 3). Only four indicators assessed outcome quality. In the majority of indicators the evidence base supporting the indicator recommendation was weak. None of the selected indicators was validated in experimental studies. Conclusions – Evidence and validation base played only a subordinate role for indicator prioritisation by stakeholders indicating that there are discrepancies between clinical questions and requirements in schizophrenia care and scientific research.

Declaration of Interest: Stefan Weinmann and Thomas Becker received an unrestricted grant from the Federal Association of Local Health Funds (AOK-BV) for the whole project. Christiane Roick is an employee of the AOK-BV. All authors declare that there are no other financing arrangements or payments that might be considered a conflict of interests related to the present paper.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

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References

Agency for Health Care Policy and Research (1994). Management Guidelines for Acute Back Pain. US Department of Health and Human Services: Washington DC.Google Scholar
Anthony, W., Rogers, E.S. & Farkas, M. (2003). Research on evidencebased practices: future directions in an era of recovery. Community Mental Health Journal 39, 101114.CrossRefGoogle Scholar
Baillie, N., Bent, N., Leng, G., Kendall, T. & Shakleton, B. (2008). NICE guidelines series and the role of indicators. Epidemiologia e Psichiatria Sociale 17, 254257.CrossRefGoogle ScholarPubMed
Bilsker, D. & Goldner, E.M. (2002). Routine outcome measurement by mental health-care providers: is it worth doing? Lancet 360, 16891690.CrossRefGoogle ScholarPubMed
Cradock, J., Young, A.S. & Sullivan, G. (2001). The accuracy of medical record documentation in schizophrenia. Journal of Behavioural Health Services Research 28, 456465.CrossRefGoogle ScholarPubMed
Donabedian, A. (1980). Explorations in Quality Assessment and Monitoring: The Definition of Quality and Approaches to Its Measurement. Health Administration Press: Ann Arbor, MI.Google Scholar
Druss, B., Rosenheck, R., Druss, B. & Rosenheck, R. (1997). Evaluation of the HEDIS measure of behavioral health care quality. Health Plan Employer Data and Information Set.[see comment]. Psychiatric Services 48, 7175.Google ScholarPubMed
Gilbody, S.M., House, A.O. & Sheldon, T.A. (2002a). Outcomes research in mental health. Systematic review. British Journal of Psychiatry 181, 816.CrossRefGoogle ScholarPubMed
Gilbody, S.M., House, A.O. & Sheldon, T.A. (2002b). Outcomes research in mental health. Systematic review. British Journal of Psychiatry 181, 816.CrossRefGoogle ScholarPubMed
Hermann, R.C. (2005). Improving Mental Healthcare. A Guide to Measurement-Based Quality Improvement. American Psychiatric Publishing: Washington, DC.Google Scholar
Hermann, R.C. & Palmer, R.H. (2002). Common ground: a framework for selecting core quality measures for mental health and substance abuse care. Psychiatric Services 53, 281287.CrossRefGoogle Scholar
Hermann, R.C., Leff, H.S., Palmer, R.H., Yang, D., Teller, T., Provost, S., Jakubiak, C. & Chan, J. (2000). Quality measures for mental health care: results from a national inventory. Medical Care Research and Review 57, Suppl 2, 136154.CrossRefGoogle ScholarPubMed
Hermann, R.C., Finnerty, M., Provost, S., Palmer, R.H., Chan, J., Lagodmos, G., Teller, T. & Myrhol, B.J. (2002). Process measures for the assessment and improvement of quality of care for schizophrenia. Schizophrenia Bulletin 28, 95104.CrossRefGoogle ScholarPubMed
Hermann, R.C., Palmer, H., Leff, S., Shwartz, M., Provost, S., Chan, J., Chiu, W.T. & Lagodmos, G. (2004). Achieving consensus across diverse stakeholders on quality measures for mental healthcare. Medical Care 42, 12461253.CrossRefGoogle ScholarPubMed
Iezzoni, L.E. (2003). Risk Adjustment for Measuring Healthcare Outcomes. Health Administration Press: Chicago.Google Scholar
Maisey, S., Steel, N., Marsh, R., Gillam, S., Fleetcroft, R. & Howe, A. (2008). Effects of payment for performance in primary care: qualitative interview study. Journal of Health Services Research & Policy 13, 133139.CrossRefGoogle ScholarPubMed
Rössler, W. (2003). Wie definiert sich Qualität in der psychiatrischen Versorgung? Nervenarzt 74, 552560.CrossRefGoogle Scholar
Ruggeri, M., Lora, A. & Semisa, D. (2008). The SIEP-DIRECTS Project on the discrepancy between routine practice and evidence. An outline of main findings and practical implications for the future of community based mental health services. Epidemiologia e Psichiatria Sociale 17, 358368.CrossRefGoogle ScholarPubMed
Salize, H.J., Rössler, W. & Becker, T. (2007). Mental health care in Germany: current state and trends. European Archives of Psychiatry and Clinical Neurosciences 257, 92103.CrossRefGoogle ScholarPubMed
Semisa, D., Lora, A., Morosini, P. & Ruggeri, M. (2008). [The SIEPDIRECTS Project on the discrepancy between routine practice and evidence in the treatment of schizophrenia. The design, the indicators, and the methodology of the study]. Epidemiologia e Psichiatria Sociale 17, 278290.CrossRefGoogle ScholarPubMed
Young, A.S., Sullivan, G., Burnam, M.A. & Brook, R.H. (1998). Measuring the quality of outpatient treatment for schizophrenia. Archives of General Psychiatry 55, 611617.CrossRefGoogle ScholarPubMed