title: The Cornell Service Index as a measure of health service use.
abstract: OBJECTIVE
  This article describes the development, administration, and reliability of the Cornell Services Index (CSI), a new instrument that measures health service use. The CSI was developed to create a standardized measure of the quantity and characteristics (for example, site and provider) of services used by adults. Descriptive data are provided to illustrate the application of the CSI in a community sample of adults who were newly admitted to outpatient mental health clinics. These data provide information about the pathways to care.
  
  
  METHODS
  The interrater and test-retest reliability of the CSI were evaluated by using a sample of 40 adults who were seeking mental health treatment. Descriptive data on service use in a sample of 1,279 adults seeking care in outpatient mental health clinics was provided to demonstrate the application of the CSI.
  
  
  RESULTS
  The CSI is a portable, easy to use, and brief assessment of service use. It has good interrater and test-retest reliability among adults without cognitive impairment. In the three months before seeking care, 31 percent of the adults interviewed had made a mental health visit, 36 percent had been hospitalized, and more than half (59 percent) had made a medical visit. Twenty-three percent of adults had sought care from a hospital's emergency department.
  
  
  CONCLUSIONS
  The CSI is a reliable method to assess health service use for adults. The measure can extend assessment of use beyond the traditional mental health service use questions and provide a snapshot of service use patterns across types, providers, and sites of service among adults who seek mental health care.
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, New York 10605, USA. jsirey@med.cornell.edu
authors.forename: Jo Anne
authors.initials: JA
authors.lastname: Sirey
authors.forename: Barnett S
authors.initials: BS
authors.lastname: Meyers
authors.forename: Jeanne A
authors.initials: JA
authors.lastname: Teresi
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
authors.forename: Mildred
authors.initials: M
authors.lastname: Ramirez
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Raue
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Perlick
authors.forename: Douglas
authors.initials: D
authors.lastname: Holmes
mesh_terms: D000554:Ambulatory Care Facilities; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003625:Data Collection / Q000379:methods; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D014481:United States