Quality indicators for international benchmarking of mental health care.

OBJECTIVE To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data. DESIGN An international expert panel employed a consensus development process to select important, sound, and feasible measures based on a framework that balances these priorities with the additional goal of assessing the breadth of mental health care across key dimensions. PARTICIPANTS Six countries and one international organization nominated seven panelists consisting of mental health administrators, clinicians, and services researchers with expertise in quality of care, epidemiology, public health, and public policy. Measures. Measures with a final median score of at least 7.0 for both importance and soundness, and data availability rated as 'possible' or better in at least half of participating countries, were included in the final set. Measures with median scores </=3.0 or data availability rated as 'unlikely' were excluded. Measures with intermediate scores were subject to further discussion by the panel, leading to their adoption or rejection on a case-by-case basis. RESULTS From an initial set of 134 candidate measures, the panel identified 12 measures that achieved moderate to high scores on desired attributes. CONCLUSIONS Although limited, the proposed measure set provides a starting point for international benchmarking of mental health care. It addresses known quality problems and achieves some breadth across diverse dimensions of mental health care.

[1]  R. Palmer,et al.  Common ground: a framework for selecting core quality measures for mental health and substance abuse care. , 2002, Psychiatric services.

[2]  G. Glover The audit of mental health services. , 1990, Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care.

[3]  Alan D. Lopez,et al.  The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020. , 1996 .

[4]  Robert M. Deiters Organization for Economic Co-Operation and Development (OECD). , 1968 .

[5]  A. Hendricks,et al.  Measuring quality of care: fundamental information from administrative datasets. , 1994, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[6]  Glen O. Gabbard,et al.  Treatments of Psychiatric Disorders , 1995, Nature Medicine.

[7]  Michael Shwartz,et al.  Achieving Consensus Across Diverse Stakeholders on Quality Measures for Mental Healthcare , 2004, Medical care.

[8]  J. Pirkis,et al.  Measuring Quality in Australian Mental Health Services , 1999 .

[9]  H. S. Leff,et al.  Quality measures for mental health care: results from a national inventory. , 2000, Medical care research and review : MCRR.

[10]  R H Brook,et al.  A Method for the Detailed Assessment of the Appropriateness of Medical Technologies , 1986, International Journal of Technology Assessment in Health Care.

[11]  C. Chew‐Graham,et al.  Quality indicators for primary care mental health services , 2003, Quality & safety in health care.

[12]  G. Glover A comprehensive clinical database for mental health care in England , 2000, Social Psychiatry and Psychiatric Epidemiology.

[13]  Sheila Leatherman,et al.  The OECD Health Care Quality Indicators Project: history and background. , 2006, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[14]  Lloyd I. Sederer,et al.  Improving Mental Health Care: A Guide to Measurement-Based Quality Improvement , 2006 .

[15]  Jeremy Hurst,et al.  Health Care Quality Indicators Project: Conceptual Framework Paper , 2006 .

[16]  M. England,et al.  Crossing the Quality Chasm: Adaptation for Mental Health and Addictive Disorders , 2005 .

[17]  D. Gifford,et al.  Development of a quality of care measurement system for children and adolescents. Methodological considerations and comparisons with a system for adult women. , 1997, Archives of pediatrics & adolescent medicine.

[18]  J. Sayers The world health report 2001 - Mental health: new understanding, new hope , 2001 .

[19]  S. Mattke,et al.  Selecting Indicators for the Quality of Mental Health Care at the Health Systems Level in OECD Countries , 2004 .

[20]  D. Gastfriend,et al.  Establishing the feasibility of performance measures for alcohol and other drugs. , 2002, Journal of substance abuse treatment.

[21]  B. Barraclough,et al.  Excess mortality of mental disorder , 1998, British Journal of Psychiatry.

[22]  Jan Mainz,et al.  Nationwide continuous quality improvement using clinical indicators: the Danish National Indicator Project. , 2004, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[23]  K. Kahn,et al.  Quality of antidepressant medications prescribed at discharge to depressed elderly patients in general medical hospitals before and after prospective payment system. , 1994, General Hospital Psychiatry.

[24]  Nelson,et al.  Shared Mental Health Care in Canada Current status , commentary and recommendations , 2001 .

[25]  R. Rosenheck,et al.  Comparing quality of mental health care for public-sector and privately insured populations. , 2000, Psychiatric services.