Routine measurement of outcomes in Australia's public sector mental health services
Tóm tắt
This paper describes the Australian experience to date with a national 'roll out' of routine outcome measurement in public sector mental health services. Consultations were held with 123 stakeholders representing a range of roles. Australia has made an impressive start to nationally implementing routine outcome measurement in mental health services, although it still has a long way to go. All States/Territories have established data collection systems, although some are more streamlined than others. Significant numbers of clinicians and managers have been trained in the use of routine outcome measures, and thought is now being given to ongoing training strategies. Outcome measurement is now occurring 'on the ground'; all States/Territories will be reporting data for 2003–04, and a number have been doing so for several years. Having said this, there is considerable variability regarding data coverage, completeness and compliance. Some States/Territories have gone to considerable lengths to 'embed' outcome measurement in day-to-day practice. To date, reporting of outcome data has largely been limited to reports profiling individual consumers and/or aggregate reports that focus on compliance and data quality issues, although a few States/Territories have begun to turn their attention to producing aggregate reports of consumers by clinician, team or service. Routine outcome measurement is possible if it is supported by a co-ordinated, strategic approach and strong leadership, and there is commitment from clinicians and managers. The Australian experience can provide lessons for other countries.
Tài liệu tham khảo
Slade M: The use of patient-level outcomes to inform treatment. Epidemiologia e Psichiatria Sociale. 2002, 11: 20-27.
Brower LA: The Ohio Mental Health Consumer Outcomes System: reflections on a major policy initiative in the US. Clinical Psychology and Psychotherapy. 2003, 10: 400-406. 10.1002/cpp.386.
Ruggeri M: Feasibility, usefulness, limitations and perspectives of routine outcome assessment: the South Verona Outcome Project. Epidemiologia e Psichiatria Sociale. 2002, 11: 177-185.
Priebe S, McCabe R, Bullenkamp J, Hansson L, Rossler W, Torres-Gonzales F, Wiersma D: The impact of routine outcome measurement on treatment processes in community mental health care: approach and methods of the MECCA study. Epidemiologia e Psichiatria Sociale. 2002, 11: 198-204.
Australian Health Ministers: National Mental Health Plan. 1992, Canberra, Australian Government Publishing Service
Australian Health Ministers: Second National Mental Health Plan. 1997, Canberra: Mental Health Branch, Commonwealth Department of Health and Family Services
Australian Health Ministers: National Mental Health Plan (2003-2008). 1998, Canberra, Australian Government
Department of Health and Ageing: National Outcomes and Casemix Collection: Overview of clinical measures and data items. Version 1.02. 2002, Canberra, Commonwealth Department of Health and Ageing
Australian Institute of Health and Welfare: Admitted patient mental health care National Minimum Data Set. National Health Data Dictionary, Version 12. AIHW Cat. No. HWI 49. 2003, Canberra, Australian Institute of Health and Welfare
Australian Institute of Health and Welfare: Community mental health establishments National Minimum Data Set. National Health Data Dictionary. Version 12. 2003, Canberra, Australian Institute of Health and Welfare
Australian Institute of Health and Welfare: Community mental health care National Minimum Data Set. National Health Data Dictionary. Version 12. 2003, Canberra, Australian Institute of Health and Welfare
Department of Health and Ageing: National Mental Health Information Priorities, 2nd Edition. Canberra, Australian Government, Forthcoming
Callaly T, Hallebone EL: Introducing the routine use of outcomes measurement to mental health services. Australian Health Review. 2001, 24: 43-50.
Rock D, Combrinck J, Groves A: Issues associated with the implementation of routine outcome measures in public mental health serivces. Australasian Psychiatry. 2001, 9: 43-46. 10.1046/j.1440-1665.2001.00303.x.
Slade M: Routine outcome assessment in mental health services. Psychological Medicine. 2002, 32: 1339-1343. 10.1017/S0033291701004974.
Wing JK, Beevor AS, Curtis RH, Park SB, Hadden S, Burns A: Health of the Nation Outcome Scales (HoNOS). Research and development. British Journal of Psychiatry. 1998, 172: 11-18.
Burns A, Beevor A, Lelliott P, Wing J, Blakey A, Orrell M, Mulinga J, Hadden S: Health of the Nation Outcome Scales for elderly people (HoNOS 65+). British Journal of Psychiatry. 1999, 174: 424-427.
Gowers SG, Harrington RC, Whitton A, Lelliott P, Beevor A, Wing J, Jezzard R: Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for children and Adolescents (HoNOSCA). British Journal of Psychiatry. 1999, 174: 413-416.
Parker G, Rosen A, Emdur N, Hadzi-Pavlovic D: The Life Skills Profile: Psychometric properties of a measure assessing function and disability in schizophrenia. Acta Psychiatrica Scandinavica. 1991, 83: 145-152.
Buckingham W, Burgess P, Solomon S, Pirkis J, Eagar K: DevelopingCasemix a Classification for Mental Health Services. Volume 1: Main Report. 1998, Canberra, Commonwealth Department of Health and Family Services,
Fries BE, Schneider DP, Foley WJ, Gavazzi M, et al: Refining a case-mix measure for nursing homes: Resource utilization groups (RUG-III). Medical Care. 1994, 32: 668-685.
Schaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S: A children's global assessment scale (CGAS). Archives of General Psychiatry. 1983, 40: 1228-1231.
Veit CT, Ware JE: The structure of psychological distress and well-being in general populations. Journal of Consulting & Clinical Psychology. 1983, 51: 730-742. 10.1037//0022-006X.51.5.730.
Eisen SV, Dickey B, Sederer LI: A self-report symptom and problem rating scale to increase inpatients' involvement in treatment. Psychiatric Services. 2000, 51: 349-353. 10.1176/appi.ps.51.3.349.
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, Walters EE, Zaslavsky AM: Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine. 2002, 32: 959-976. 10.1017/S0033291702006074.
Goodman R: The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology & Psychiatry & Allied Disciplines. 1997, 38: 581-586.
Department of Health and Ageing: Mental Health National Outcomes and Casemix Collection: Overview of clinician rated and consumer self-report measures, Version 1.50. 2003, Canberra, Department of Health and Ageing