+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Clinic comparisons as an instrument for quality assurance in the treatment of patients with mental disorders: the significance of risk adjustment



Clinic comparisons as an instrument for quality assurance in the treatment of patients with mental disorders: the significance of risk adjustment



Zeitschrift für Arztliche Fortbildung und Qualitatssicherung 98(8): 663-672



It is becoming increasingly more relevant for health care providers to also participate in external quality assurance measures. A few systematic approaches that also integrate outcome quality and include a comparison of different clinics have only recently been developed for the area of the treatment of patients with mental disorders. In this context, a key issue is the appropriate consideration of confounders, i.e., of unevenly distributed patient characteristics that are causally related to the treatment results. Using a sample of consecutive patients from four psychotherapeutic clinics, we exemplarily examined the significance of the confounders for the comparison of the clinics with regard to short-term outcome. The results show that an adjustment is principally advisable and is generally associated with a reduction of the differences in treatment results. The discussion asserts that the use of regression weights, which were ascertained using an independent, representative sample, allows for a more valid risk adjustment. Finally, reference will be made to the relevance of giving consideration to varying resource usage in the assessment of the risk-adjusted clinic comparisons.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 048531113

Download citation: RISBibTeXText

PMID: 15646729


Related references

Methods of research and some aspects of morbidity and hospital outpatient clinic treatment of mental disorders. III. Results of the use of outpatient clinic methods in mental disorders in the years 1966-1970. Revista de Medicina Interna, Neurologie, Psihiatrie, Neurochirurgie, Dermato-Venerologie. Neurologie, Psihiatrie, Neurochirurgie 20(2): 119-127, 1975

Significance of quality assurance as an instrument for improving integrating and coordinating health care. Gesundheitswesen ) 62(1 Suppl): S72-S75, 2000

Risk adjustment in external quality assurance with multivariate analysis. Zentralblatt für Chirurgie 125 Suppl 2: 127-129, 2001

Ethnic comparisons of the 12 month prevalence of mental disorders and treatment contact in Te Rau Hinengaro: the New Zealand Mental Health Survey. Australian and New Zealand Journal of Psychiatry 40(10): 905-913, 2006

The effect of a pathology clinic on the mental state and adjustment of patients with breast cancer. Palliative & Supportive Care 13(6): 1615-1621, 2016

The Adolescent Adjustment Profile (AAP) in comparisons of patients with obesity, phenylketonuria or neurobehavioural disorders. Nordic Journal of Psychiatry 62(1): 66-76, 2008

The Hoosier Assurance Plan Instrument for Adults (HAPI-A): the psychometric properties of a level of functioning assessment instrument designed for use in a state managed care mental health program. Community Mental Health Journal 43(5): 481-515, 2007

Integrated medical care in a mental health clinic improved quality of care and outcomes in serious mental disorders. Evidence-Based Mental Health 5(2): 46-46, 2002

Enhancing treatment outcome of patients at risk of treatment failure: meta-analytic and mega-analytic review of a psychotherapy quality assurance system. Journal of Consulting and Clinical Psychology 78(3): 298-311, 2010

Quality assurance The quality assurance project undertaken by the english national board for nursing, midwifery and health visiting (ENB) has been completed, leading to a revised quality assurance framework. A publication, quality assurance manual, has been developed for ENB education staff to ensure uniform implementation of the framework throughout england, and is summarised here. Nursing Standard 1987) 13(15): 41-41, 1998

Quality assurance study of hyponatremia in patients with carbamazepine in an epilepsy outpatient clinic. Epilepsia 30(5): 638, 1989

Optimizing ACS NSQIP modeling for evaluation of surgical quality and risk: patient risk adjustment, procedure mix adjustment, shrinkage adjustment, and surgical focus. Journal of the American College of Surgeons 217(2): 336-46.E1, 2013

Development and validation of a quality of life instrument for patients with drug dependence: comparisons with SF-36 and WHOQOL-100. International Journal of Nursing Studies 48(9): 1080-1095, 2011

Does retirement reduce the risk of mental disorders? A national registry-linkage study of treatment for mental disorders before and after retirement of 245,082 Danish residents. Occupational and Environmental Medicine 72(5): 366-372, 2015

Risk factors for mental disorders in patients with hypertensive intracerebral hemorrhage following neurosurgical treatment. Journal of the Neurological Sciences 341(1-2): 128-132, 2014