Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Leslie, D. L. Articles by Rosenheck, R. A. Search for Related Content PubMed Citation Articles by Leslie, D. L. Articles by Rosenheck, R. A. Veterans Access to Services Quality of Care, Practice Guidelines

Comparing Quality of Mental Health Care for Public-Sector and Privately Insured Populations

OBJECTIVE: This study examined the methodological difficulties of comparing quality of care in large health care systems. It demonstrated methods for measuring quality of mental health care and, using these measures, compared patients from Department of Veterans Affairs (VA) hospitals with privately insured patients. METHODS: Individuals receiving VA inpatient mental health care during the first six months of each fiscal year from 1993 to 1997 were identified from discharge abstracts. A similar cohort of privately insured individuals was identified using MEDSTAT's MarketScan database from 1993 to 1995. Individuals in both cohorts were tracked for six months after discharge. Length of stay, readmission rates, and access to outpatient services were calculated. RESULTS: The private sector outperformed VA on most quality measures, although differences were modest and can likely be explained by the greater severity of illness and social disadvantages of VA patients. Readmission rates increased considerably over time in the private sector, whereas they declined for VA patients. Quality measures varied by diagnosis, with VA performing better than the private sector in treating patients diagnosed with substance abuse and mental disorders not elsewhere classified but worse in treating patients diagnosed with depression. CONCLUSIONS: Although the private sector modestly outperformed VA on most quality measures, VA treats a more troubled population, and it improved markedly over time compared with the private sector. As health systems strive to reduce costs of care, methods for comparing and evaluating the quality of care become increasingly important. However, methodological challenges remain substantial.

This article has been cited by other articles:

				R. C. Hermann, J. A. Chan, S. E. Provost, and W. T. Chiu Statistical Benchmarks for Process Measures of Quality of Care for Mental and Substance Use Disorders Psychiatr Serv, October 1, 2006; 57(10): 1461 - 1467. [Abstract] [Full Text] [PDF]

				R. C. Hermann, S. Mattke, D. Somekh, H. Silfverhielm, E. Goldner, G. Glover, J. Pirkis, J. Mainz, and J. A. Chan Quality indicators for international benchmarking of mental health care Int. J. Qual. Health Care, September 1, 2006; 18(suppl_1): 31 - 38. [Abstract] [Full Text] [PDF]

				S. H. Busch, D. L. Leslie, and R. A. Rosenheck Comparing the Quality of Antidepressant Pharmacotherapy in the Department of Veterans Affairs and the Private Sector Psychiatr Serv, December 1, 2004; 55(12): 1386 - 1391. [Abstract] [Full Text] [PDF]

				S. M. GILBODY, A. O. HOUSE, and T. A. SHELDON Outcomes research in mental health: Systematic review The British Journal of Psychiatry, July 1, 2002; 181(1): 8 - 16. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2000 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us