title: Predicting patient deterioration in youth mental health services: community mental health vs. managed care settings.
abstract: OBJECTIVE
  To examine differences across a community mental health system and a private managed care system in the accuracy of a warning system designed to identify youth at risk for deterioration in mental health services.
  
  
  METHODS
  Longitudinal outcome data from the Youth Outcome Questionnaire (Y-OQ) were examined using multilevel modeling for 2,310 youth ages 4-17 who received outpatient treatment.
  
  
  RESULTS
  The warning system correctly identified 69% of cases that ultimately ended in deterioration in the community mental health setting, compared to 61% in the managed care setting. The overall hit rate (overall accuracy in classifying cases as deteriorators/non-deteriorators) was the same in the two settings (75%).
  
  
  CONCLUSIONS
  Results are consistent with previous research demonstrating that patient-focused warning systems can be reasonably accurate in identifying youth cases at risk for treatment failure.
authors: Brigham Young University, Provo, UT 84602, USA. jared_warren@byu.edu
authors: Jared S
authors: JS
authors: Warren
authors: Philip L
authors: PL
authors: Nelson
authors: Gary M
authors: GM
authors: Burlingame
authors: Sasha A
authors: SA
authors: Mondragon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000592:standards*; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services; D010045:Outpatients / Q000145:classification* / Q000523:psychology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D017211:Treatment Failure