The Cornell Service Index as a measure of health service use.
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.
Sirey
Jo Anne
JA
Department of Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, New York 10605, USA. jsirey@med.cornell.edu
Meyers
Barnett S
BS
Teresi
Jeanne A
JA
Bruce
Martha L
ML
Ramirez
Mildred
M
Raue
Patrick J
PJ
Perlick
Deborah A
DA
Holmes
Douglas
D
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