Veterans Health Administration Mental Health Program Evaluation Technical Manual

Horvitz-Lennon, Marcela; Watkins, Katherine E.; Pincus, Harold Alan; Shugarman, Lisa R.; Smith, Brad; Mattox, Teryn; Mannle, Thomas E.

doi:10.1037/e646132010-001

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…The specification of four psychotherapy visits within eight weeks is consistent with a recommendation in the VA/DoD PTSD clinical practice guideline (Department of Veterans Affairs and Department of Defense, 2010), although a particular number of sessions in this time frame is not mentioned. This metric is also consistent with technical specifications used in the VA Mental Health Program Evaluation (Horvitz-Lennon et al, 2009). An alternate level of care of two evaluation and management visits for the purpose of medication management is recommended by the VA/ DoD practice guidelines (Department of Veterans Affairs and Department of Defense, 2009).…”

Section: Measure Overviewsupporting

confidence: 63%

Quality of Care for PTSD and Depression in the Military Health System: Phase I Report

Hepner¹,

Sloss²,

Roth³

et al. 2016

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This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.html.The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest.RAND's publications do not necessarily reflect the opinions of its research clients and sponsors. For more information on this publication, visit www.rand.org/t/RR978 Support RANDPublished by the RAND Corporation, Santa Monica, Calif. © Copyright 2016 RAND CorporationR® is a registered trademark. Cover: U.S. Air Force photo by Senior Airman Tabatha Zarrella iii PrefaceThe U.S. Department of Defense (DoD) strives to maintain a physically and psychologically healthy, mission-ready force, and the care provided by the Military Health System (MHS) is critical to meeting this goal. Given the rates of posttraumatic stress disorder (PTSD) and depression among U.S. service members, attention has been directed to ensuring the quality and availability of programs and services targeting these and other psychological health (PH) conditions. Understanding the current quality of care for PTSD and depression is an important step toward future efforts to improve care across the MHS.To help determine whether the service members with PTSD and/or depression are receiving evidence-based care and whether there are disparities in care quality by branch of service, geographic region, and service member characteristics (e.g., gender, age, pay grade, race/ethnicity, deployment history), DoD's Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) asked the RAND Corporation to conduct a review of the administrative data and medical records of service members diagnosed with PTSD and/or depression and to recommend areas on which the MHS could focus its efforts to continuously improve the quality of care provided to all service members.This report should be of interest to MHS personnel who provide care for service members with PTSD and/or depression. It should also be useful to those responsible for monitoring the quality of that care and developing evidence-based quality measures to improve care for service members and individuals with PTSD or depression in other health systems.This research was sponsored by DCoE and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of ...

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Section: Measure Overviewsupporting

confidence: 63%

Quality of Care for PTSD and Depression in the Military Health System: Phase I Report

Hepner¹,

Sloss²,

Roth³

et al. 2016

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show abstract

“…Unlike HEDIS, we excluded emergency room visits. Following from the process used to develop the technical specifications for the indicators including an advisory group composed of representatives from VHA Patient Care Services and VHA Office of Mental Health, we used a 5-month clean period rather than the HE-DIS 60-day period for SUD treatment initiation and engagement to reduce the chance of including in the denominator patients in maintenance treatment versus the active treatment phase (Horvitz-Lennon et al, 2009). Another limitation when comparing the treatment initiation and engagement indicators used here to the HEDIS specification or to other specifications used by VHA is that alternative denominator specifications could alter process-outcomes associations.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment initiation was defined as at least one SUD-related treatment visit within 14 days of the index visit, and treatment engagement was defined as receiving an additional two SUD-related treatment visits within 30 days after the initiation visit, among those who had initiated. Unlike the HEDIS specifications, the treatment initiation and engagement indicators presented here and used for the FY07 external evaluation of VHA mental health care specified that the index visit must occur after a period of 5 months rather than 60 days without any SUD-related visits before the index visit (Horvitz-Lennon et al, 2009). Thus, this indicator was limited to individuals who were not currently in treatment (Harris et al, 2015a).…”

Section: Methodsmentioning

confidence: 99%

Association Between Process Based Quality Indicators and Mortality for Patients With Substance Use Disorders

Paddock

Hepner

Hudson

et al. 2017

J. Stud. Alcohol Drugs

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Substance use disorders (SUDs) are associated with elevated rates of mortality. Little is known about whether receiving appropriate care is associated with lower mortality for patients with SUDs. This study examined the association between the receipt of care for SUDs and subsequent 12-and 24-month mortality. Method: This was a retrospective cohort study of veterans who received care for SUDs paid for by the Veterans Health Administration during October 2006-September 2007 (n = 339,966). Logistic regressions were used to examine the association between quality indicators measuring receipt of care and mortality while controlling for patient characteristics and facility service area. Results: There were four quality indicators: SUD treatment initiation, SUD treatment engagement, SUD-related psychosocial treatment, and SUD-related psychotherapy. Outcomes measured were mortality 12 and 24 months after the end of the observation period, through September 2009. Receipt of indicated care ranged from 26.5% to 58.6%, and 12-and 24-month mortality rates were 3% and 6%, respectively.

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“…Twenty-five candidate measures were identified through a review of peer-reviewed literature on development and evaluation of quality measures related to care for alcohol and drug use (Horovitz-Lennon et al, 2009), clinical practice guidelines (Kleber et al, 2006; National Institute for Health and Clinical Excellence, 2011; U.S. Department of Veterans Affairs and U.S. Department of Defense, 2009), and measure databases (e.g., National Quality Forum).…”

Section: Methodsmentioning

confidence: 99%

Quality of care measures for the management of unhealthy alcohol use

Hepner

Watkins

Farmer

et al. 2017

Journal of Substance Abuse Treatment

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There is a paucity of quality measures to assess the care for the range of unhealthy alcohol use, ranging from risky drinking to alcohol use disorders. Using a two-phase expert panel review process, we sought to develop an expanded set of quality of care measures for unhealthy alcohol use, focusing on outpatient care delivered in both primary care and specialty care settings. This process generated 25 candidate measures. Eight measures address screening and assessment, 11 address aspects of treatment, and six address follow-up. These quality measures represent high priority targets for future development, including creating detailed technical specifications and pilot testing them to evaluate their utility in terms of feasibility, reliability, and validity.

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Veterans Health Administration Mental Health Program Evaluation Technical Manual

Cited by 9 publications

References 27 publications

Quality of Care for PTSD and Depression in the Military Health System: Phase I Report

Quality of Care for PTSD and Depression in the Military Health System: Phase I Report

Association Between Process Based Quality Indicators and Mortality for Patients With Substance Use Disorders

Quality of care measures for the management of unhealthy alcohol use

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