[Quality Indicators for Integrated Care in Patients with Schizophrenia - Results from a Feasibility Study].
ObjectiveThe study aimed to evaluate the applicability of a set of quality indicators to assess models of integrated care for patients with a diagnosis of schizophrenia. We report first values for these indicators in routine care in Germany.MethodsThe study is based on a cohort of adult patients with schizophrenia insured by one large German statutory health insurance company, which were assessed two times and gave consent to evaluate their routine claims data. The study tried to use 12 basic and 22 quality indicators from claims data.ResultsIt was possible to estimate most structural indicators using available data, but only half of the quality indicators. This means that while assessment of quality indicators is feasible in general, routine claims data needs to be supplemented by additional (primary) data. Four of the calculated quality indicators had clear targets or red-flag values, which were not met in our cohort in all four indicators. None of the patients had an outpatient mental health related contact within one week (target > 90 %). The readmission rate within 30 days (21 %) was twice as high as the proposed red-flag value of 10 %. Similar figures were seen for antipsychotic polypharmacy (25 %, red-flag value > 10 %) and the proportion of patients with compulsory treatment (15 %) exceeded the red-flag value by 5 %.ConclusionThe study shows that it is possible to measure quality indicators, but also demonstrates considerable limitations. There is a need to validate indicators in routine care.
Klinik für Psychiatrie und Psychotherapie II der Universität Ulm, Bezirkskrankenhaus Günzburg.
Markus
M
Kösters
Klinik für Psychiatrie und Psychotherapie II der Universität Ulm, Bezirkskrankenhaus Günzburg.
Lena
L
Staudigl
Klinik für Psychiatrie und Psychotherapie II der Universität Ulm, Bezirkskrankenhaus Günzburg.
Ann-Christien
AC
Picca
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Augsburg.
Max
M
Schmauß
Klinik für Psychiatrie und Psychotherapie II der Universität Ulm, Bezirkskrankenhaus Günzburg.
Thomas
T
Becker
Universitäre Psychiatrische Kliniken Basel, Schweiz.
Stefan
S
Weinmann
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003134:Commitment of Persons with Psychiatric Disorders / Q000592:standards; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D019984:Quality Indicators, Health Care; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology