THE STUDY OF THE QUALITY OF CARE FOR INDIVIDUALS WITH PSYCHIATRIC DISORDERS

The Department of Psychiatry, Harvard Medical School

The Cambridge Health Alliance

Barbara Dickey, PhD; Norma Ware, PhD; Dharma Cortes,PhD; Sharon-Lise Normand, PhD; Marcella Horvitz-Lennon, PhD

This research program combines several methodological approaches to the study of the care of individuals with serious mental disorders. One approach has been the acquisition of large administrative datasets to examine patterns of care, the use of pharmaceutical interventions and variation in population-based performance indicators. A second approach has been qualitative - in-depth interviews with service users about their definition of quality and their pathways to treatment. We have also interviewed administrators of psychiatric programs to understand how they structure their treatment programs and whether experience with managed care organizations has changed how they deliver care. Third, we have conducted structured surveys of individuals treated for schizophrenia to assess their clinical condition, their perception of their clinician- relationship and the satisfaction with their services. Finally, we have abstracted inpatient and outpatient records to determine their adherence to disease-specific practice guidelines.

Grant Support. NIMH.

Project Sites. The primary research site is The Cambridge Health Alliance. Dr. Normand is with the Department of Health Care Policy, Harvard Medical School and Dr. Horvitz-Lennon has a joint appointment in the Department of Health Care Policy and the Department of Psychiatry, The Cambridge Health Alliance.

Project Director. Barbara Dickey, PhD; The Cambridge Health Alliance, 1493 Cambridge Street, Cambridge MA 02139. Phone: 617-503-2381; FAX: 617-503-2426

Representative Publications:

Dickey B, Eisen SV, Hermann R. Assessing the quality of psychiatric care: methods in research and clinical practice. Harvard Review of Psychiatry. 1998; 6:88-96.

Dickey B, Azeni H, Weiss R, Sederer L. Schizophrenia, substance use disorder and medical co-morbidity.

The Journal of Mental Health Policy and Economics, 3:1, 2000.

Dickey B. Review of Programs for People who are Homeless and Mentally Ill. Harvard Review of

Psychiatry. 2000; 8:242-250

Dickey B. Measuring Outcomes in Women's Mental Health, Women's Health Issues,

2000;10: July-August

Dickey B, Sederer LI, eds. Improving Mental Health Care: Commitment to Quality. Washington DC:

American Psychiatric Association Press, Inc. 2001