National Child Mental Health Quality Measures: Adherence Rates and Extent of Evidence for Clinical Validity

Zima, Bonnie T.; Edgcomb, Juliet Beni; Shugarman, Samantha

doi:10.1007/s11920-019-0986-3

Cited by 11 publications

(14 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our analysis of Medicaid data from 11 states, we found that a majority of children aged 6 to 17 years had any mental health outpatient follow-up, with higher rates than previously found for this national HEDIS quality measure. 7,8 Just under two-thirds had follow-up within 7 days, and .80% had follow-up within 30 days. Lower rates of follow-up were seen for certain groups, including non-Hispanic or non-Latino black children and those children discharged from a general medical or surgical unit for mental health illness as opposed to a psychiatric unit or hospital.…”

Section: Discussionmentioning

confidence: 98%

“…7 Rates of performance nationally for this measure range from 47.5% of children and youth hospitalized for a mental illness having a follow-up visit within 7 days of hospital discharge to 66.7% having at least one follow-up visit within 30 days of discharge. 7,8 However, there are few studies on how this quality measure's performance varies by race and/or ethnicity and socioeconomic, clinical, or hospital characteristics and whether this adherence to the quality measure is associated with improved patient outcomes. Answering these questions can inform efforts to improve quality, identifying patients at higher risk of poor-quality care and potentially worse outcomes.…”

mentioning

confidence: 99%

See 1 more Smart Citation

ED Visits and Readmissions After Follow-up for Mental Health Hospitalization

et al. 2020

Self Cite

View full text Add to dashboard Cite

OBJECTIVES: A national quality measure in the Child Core Set is used to assess whether pediatric patients hospitalized for a mental illness receive timely follow-up care. In this study, we examine the relationship between adherence to the quality measure and repeat use of the emergency department (ED) or repeat hospitalization for a primary mental health condition. METHODS:We used the Truven MarketScan Medicaid Database 2015-2016, identifying hospitalizations with a primary diagnosis of depression, bipolar disorder, psychosis, or anxiety for patients aged 6 to 17 years. Primary predictors were outpatient follow-up visits within 7 and 30 days. The primary outcome was time to subsequent mental health-related ED visit or hospitalization. We conducted bivariate and multivariate analyses using Cox proportional hazard models to assess relationships between predictors and outcome.RESULTS: Of 22 844 hospitalizations, 62.0% had 7-day follow-up, and 82.3% had 30-day followup. Subsequent acute use was common, with 22.4% having an ED or hospital admission within 30 days and 54.8% within 6 months. Decreased likelihood of follow-up was associated with non-Hispanic or non-Latino black race and/or ethnicity, fee-for-service insurance, having no comorbidities, discharge from a medical or surgical unit, and suicide attempt. Timely outpatient follow-up was associated with increased subsequent acute care use (hazard ratio [95% confidence interval]: 7 days: 1.20 [1.16-1.25]; 30 days: 1.31 [1.25-1.37]). These associations remained after adjusting for severity indicators.CONCLUSIONS: Although more than half of patients received follow-up within 7 days, variations across patient population suggest that care improvements are needed. The increased hazard of subsequent use indicates the complexity of treating these patients and points to potential opportunities to intervene at follow-up visits.WHAT'S KNOWN ON THIS SUBJECT: A nationally endorsed pediatric quality measure is used to assess rates of timely followup for patients hospitalized for a mental health diagnosis. Rates range from 48% to 67%, but little is known about variations by patient characteristics or about the relationship between followup and a subsequent psychiatric crisis.

show abstract

Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

ED Visits and Readmissions After Follow-up for Mental Health Hospitalization

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…A recent review of the limited evidence on the use of telehealth for psychiatric emergencies suggested that it can be cost-effective, reduce admission rates and length of hospitalisation, increase confidence of professionals, has validity similar to face-to-face care and has been evidenced as satisfactory among patients and practitioners. 9 The review also showed that implementation to date has primarily been areas with higher needs, such as rural locations or in large emergency departments. However, evidence for treatment of patients with severe mental illness is scarce, and many services exclude patients who are suicidal.…”

Section: The Evidence and Ethics Of Telepsychiatry For Detentionmentioning

confidence: 99%

“…However, evidence for treatment of patients with severe mental illness is scarce, and many services exclude patients who are suicidal. 9 Furthermore, a systematic review of trials of telehealth services for individuals with severe mental illness included interventions such as medication adherence, patient education and self-management. The authors concluded that ‘not all technology is effective, depending on the outcome of interest’ and some interventions did not have better outcomes than nurse-based interventions and had lower acceptability.…”

Section: The Evidence and Ethics Of Telepsychiatry For Detentionmentioning

confidence: 99%

Limits of remote working: the ethical challenges in conducting Mental Health Act assessments during COVID-19

Schölin¹,

Connolly²,

Morgan³

et al. 2021

J Med Ethics

View full text Add to dashboard Cite

COVID-19 has created additional challenges in mental health services, including the impact of social distancing measures on care and treatment. For situations where a detention under mental health legislation is required to keep an individual safe, psychiatrists may consider whether to conduct an assessment in person or using video technology. The Mental Health (Care and Treatment) (Scotland) Act 2003 does not stipulate that an assessment has to be conducted in person. Yet, the Code of Practice envisions that detention assessments would be conducted face to face in all circumstances. During the pandemic, the Mental Welfare Commission for Scotland, a statutory body with a duty to promote best practice of the Act, has been asked whether it may be acceptable and indeed preferable for some assessments to be conducted via video technology. Where an assessment is needed to determine if a patient needs to be detained, and where there is a need for social distancing or the need for ‘shielding’, remote assessments may in some circumstances be preferable. In this article, we outline the modification of the Mental Welfare Commission’s previous outright rejection of virtual assessments as the pandemic progressed and discuss the ethical and legal issues the possibility of remote assessments has exposed. We also discuss the limits and when a virtual assessment is not considered ethical. As the pandemic moves from a state of emergency into a ‘new normal’ in psychiatric services during second, or subsequent, waves, the use and place (if any) of remote assessments for detention needs to be considered.

show abstract

“…Quality indicators or performance measures exist to, ideally, guide quality improvement efforts. Nationally recognized quality measures include indicators from the National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set (HEDIS); exemplars include follow-up care for medication treatment for youth with attention deficit hyperactivity disorder and continuity of care following hospitalization (Zima, Edgcomb, & Shugarman, 2019). Yet, major critiques of existing indicators include challenges with feasibility, insufficient data supporting predictive validity for outcome improvement, and concerns that they set too low a threshold for quality care (Hayward, 2007;Pincus, Scholle, Spaeth-Rublee, Hepner, & Brown, 2016).…”

Section: Quality Indicatorsmentioning

confidence: 99%

Caregiver Attendance as a Quality Indicator in the Implementation of Multiple Evidence-Based Practices for Children

Barnett

Lau

Lind

et al. 2019

Journal of Clinical Child & Adolescent Psychology

View full text Add to dashboard Cite

and Child and Adolescent Services Research CenterObjective: This study investigated a quality indicator for children's mental health, caregiver attendance in youth psychotherapy sessions, within a system-driven implementation of multiple evidence-based practices (EBPs) in children's community mental health services. Method: Administrative claims from nine fiscal years were analyzed to characterize and predict caregiver attendance. Data included characteristics of therapists (n = 8,626), youth clients (n = 134,368), sessions (e.g., individual, family), and the EBP delivered. Clients were primarily Latinx (63%), male (54%) and mean age was 11; they presented with a range of mental health problems. Threelevel mixed models were conducted to examine the association between therapist, youth, service, EBP characteristics and caregiver attendance. Results: Caregivers attended, on average, 46.0% of sessions per client for the full sample and 59.6% of sessions for clients who were clinically indicated, based on age and presenting problem, to receive caregiver-focused treatment.

show abstract

National Child Mental Health Quality Measures: Adherence Rates and Extent of Evidence for Clinical Validity

Cited by 11 publications

References 40 publications

ED Visits and Readmissions After Follow-up for Mental Health Hospitalization

ED Visits and Readmissions After Follow-up for Mental Health Hospitalization

Limits of remote working: the ethical challenges in conducting Mental Health Act assessments during COVID-19

Caregiver Attendance as a Quality Indicator in the Implementation of Multiple Evidence-Based Practices for Children

Contact Info

Product

Resources

About