Factors associated with quality of services for marginalized groups with mental health problems in 14 European countries

BMC Health Services Research

Stefan Priebe⁸  Henrique Barros⁴  Andrea Gaddini^1,10  Joaquim JF Soares⁹  Martijn Kikkert^1,12  Christa Straßmayr³  José Manuel Díaz–Olalla⁶  Jacek Moskalewicz^1,11  Pablo Nicaise¹  Ulrike Kluge^1,13  Petra Vondráčková⁷  Tim Greacen²  Edina Gabor⁵  Reamonn Canavan^1,14  Aleksandra Matanov⁸  Diogo Costa⁴ 

[1] Institute of Health and Society (IRSS), Université Catholique de Louvain, Bruxelles, Belgium;Laboratoire de recherche, Etablissement public de santé Maison Blanche, Paris, France;Ludwig Boltzmann Institute for Social Psychiatry, Vienna, Austria;Institute of Public Health, University of Porto, Porto, Portugal;National Institute for Health Development, Budapest, Hungary;Madrid Salud, Madrid, Spain;Department of Addictology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic;Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom;Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden;Laziosanità ASP–Public Health Agency, Lazio Region, Rome, Italy;Institute of Psychiatry and Neurology, Warsaw, Poland;Arkin Institute for Mental Health Care, Amsterdam, The Netherlands;Clinic for Psychiatry and Psychotherapy, Charite, University Medicine Berlin, CCM, Berlin, Germany;Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland

关键词: Multi-level analysis;    Socially marginalized groups;    Quality index of service organization;    Mental health services;   

Others  :  1134200
DOI  :  10.1186/1472-6963-14-49

 received in 2013-06-28, accepted in 2014-01-29,  发布年份 2014

【 摘 要 】

Background

Different service characteristics are known to influence mental health care delivery. Much less is known about the impact of contextual factors, such as the socioeconomic circumstances, on the provision of care to socially marginalized groups.

The objectives of this work were to assess the organisational characteristics of services providing mental health care for marginalized groups in 14 European capital cities and to explore the associations between organisational quality, service features and country-level characteristics.

Methods

617 services were assessed in two highly deprived areas in 14 European capital cities. A Quality Index of Service Organisation (QISO) was developed and applied across all sites. Service characteristics and country level socioeconomic indicators were tested and related with the Index using linear regressions and random intercept linear models.

Results

The mean (standard deviation) of the QISO score (minimum = 0; maximum = 15) varied from 8.63 (2.23) in Ireland to 12.40 (2.07) in Hungary. The number of different programmes provided was the only service characteristic significantly correlated with the QISO (p < 0.05). The national Gross Domestic Product (GDP) was inversely associated with the QISO. Nearly 15% of the variance of the QISO was attributed to country-level variables, with GDP explaining 12% of this variance.

Conclusions

Socioeconomic contextual factors, in particular the national GDP are likely to influence the organisational quality of services providing mental health care for marginalized groups. Such factors should be considered in international comparative studies. Their significance for different types of services should be explored in further research.

【 授权许可】

   
2014 Costa et al.; licensee BioMed Central Ltd.

【 图 表 】

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