Does monitoring need for care in patients diagnosed with severe mental illness impact on Psychiatric Service Use? Comparison of monitored patients with matched controls

BMC Psychiatry

Research Article

Miriam Dietvorst¹  Ger Driessen¹  Marjan Drukker¹  Jim van Os²  Philippe Delespaul³  Sjoerd Sytema⁴ 

[1] Department of Psychiatry and Psychology, School for Mental Health and NeuroScience MHeNS, Maastricht University, The Netherlands;Department of Psychiatry and Psychology, School for Mental Health and NeuroScience MHeNS, Maastricht University, The Netherlands;Department of Psychosis Studies, Institute of Psychiatry, King's College London, King's Health Partners, London, UK;Department of Psychiatry and Psychology, School for Mental Health and NeuroScience MHeNS, Maastricht University, The Netherlands;Integrated Care Division, Mondriaan, South-Limburg, The Netherlands;Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;

关键词: Propensity Score;    Index Date;    Severe Mental Illness;    Brief Psychiatric Rate Scale;    Routine Outcome Monitoring;   

DOI  :  10.1186/1471-244X-11-45

 received in 2010-10-28, accepted in 2011-03-21,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundEffectiveness of services for patients diagnosed with severe mental illness (SMI) may improve when treatment plans are needs based. A regional Cumulative Needs for Care Monitor (CNCM) introduced diagnostic and evaluative tools, allowing clinicians to explicitly assess patients' needs and negotiate treatment with the patient. We hypothesized that this would change care consumption patterns.MethodsPsychiatric Case Registers (PCR) register all in-patient and out-patient care in the region. We matched patients in the South-Limburg PCR, where CNCM was in place, with patients from the PCR in the North of the Netherlands (NN), where no CNCM was available. Matching was accomplished using propensity scoring including, amongst others, total care consumption and out-patient care consumption. Date of the CNCM assessment was copied to the matched controls as a hypothetical index date had the CNCM been in place in NN. The difference in care consumption after and before this date (after minus before) was analysed.ResultsCompared with the control region, out-patient care consumption in the CNCM region was significantly higher after the CNCM index date regardless of treatment status at baseline (new, new episode, persistent), whereas a decrease in in-patient care consumption could not be shown.ConclusionsMonitoring patients may result in different patterns of care by flexibly adjusting level of out-patient care in response to early signs of clinical deterioration.

【 授权许可】

CC BY   
© Drukker et al; licensee BioMed Central Ltd. 2011