Comparison of psychiatrists' and other physicians' assessments of their ability to deliver high-quality care.
OBJECTIVE
This study compared psychiatrists' assessments of their ability to deliver high-quality care with those of other physicians.


METHODS
Data were used from the Community Tracking Study Physician Survey, a national survey of 12,528 physicians. Linear regression models were used to investigate the effects of type of physician (psychiatrist or other physician), managed care involvement, and ability to obtain inpatient care on four measures of physicians' assessments of quality.


RESULTS
In models that did not control for difficulty in obtaining inpatient services, assessments of quality were significantly lower among psychiatrists than among other physicians. Furthermore, although managed care involvement was associated with lower assessments of quality for all physicians in these models, the effects were stronger for psychiatrists than for other physicians. However, after difficulty in obtaining inpatient services was controlled for, psychiatrists' and other physicians' assessments of quality were similar.


CONCLUSIONS
Compared with other physicians, psychiatrists' assessments of the quality of care that they provide were lower and their assessments were more influenced by involvement with managed care. These differences may be mediated by difficulty in obtaining inpatient services. When designing and administering behavioral health benefits packages, clinical policy makers should consider the possible effects of reduction in inpatient services on quality of care.
Edlund
Mark J
MJ
Department of Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, North Little Rock, Arkansas 72114, USA. edlundmarkj@uams.edu
Belin
Thomas R
TR
Tang
Lingqi
L
Liao
Diana
D
Unützer
Jürgen
J
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003156:Community Mental Health Services / Q000592:standards; D006801:Humans; D008329:Managed Care Programs; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D010820:Physicians / Q000523:psychology*; D011570:Psychiatry / Q000379:methods / Q000592:standards*; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014481:United States