[Clinic comparisons as an instrument for quality assurance in the treatment of patients with mental disorders: the significance of risk adjustment]
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[Clinic comparisons as an instrument for quality assurance in the treatment of patients with mental disorders: the significance of risk adjustment]. / Schulz, Holger; Barghaan, Dina; Watzke, Birgit; Koch, Uwe; Harfst, Timo.
in: Z Arztl Fortbild Qualitatssich, Jahrgang 98, Nr. 8, 8, 2004, S. 663-672.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - [Clinic comparisons as an instrument for quality assurance in the treatment of patients with mental disorders: the significance of risk adjustment]
AU - Schulz, Holger
AU - Barghaan, Dina
AU - Watzke, Birgit
AU - Koch, Uwe
AU - Harfst, Timo
PY - 2004
Y1 - 2004
N2 - It is becoming increasingly more relevant for health care providers to also participate in external quality assurance measures. A few systematic approaches that also integrate outcome quality and include a comparison of different clinics have only recently been developed for the area of the treatment of patients with mental disorders. In this context, a key issue is the appropriate consideration of confounders, i.e., of unevenly distributed patient characteristics that are causally related to the treatment results. Using a sample of consecutive patients from four psychotherapeutic clinics, we exemplarily examined the significance of the confounders for the comparison of the clinics with regard to short-term outcome. The results show that an adjustment is principally advisable and is generally associated with a reduction of the differences in treatment results. The discussion asserts that the use of regression weights, which were ascertained using an independent, representative sample, allows for a more valid risk adjustment. Finally, reference will be made to the relevance of giving consideration to varying resource usage in the assessment of the risk-adjusted clinic comparisons.
AB - It is becoming increasingly more relevant for health care providers to also participate in external quality assurance measures. A few systematic approaches that also integrate outcome quality and include a comparison of different clinics have only recently been developed for the area of the treatment of patients with mental disorders. In this context, a key issue is the appropriate consideration of confounders, i.e., of unevenly distributed patient characteristics that are causally related to the treatment results. Using a sample of consecutive patients from four psychotherapeutic clinics, we exemplarily examined the significance of the confounders for the comparison of the clinics with regard to short-term outcome. The results show that an adjustment is principally advisable and is generally associated with a reduction of the differences in treatment results. The discussion asserts that the use of regression weights, which were ascertained using an independent, representative sample, allows for a more valid risk adjustment. Finally, reference will be made to the relevance of giving consideration to varying resource usage in the assessment of the risk-adjusted clinic comparisons.
M3 - SCORING: Zeitschriftenaufsatz
VL - 98
SP - 663
EP - 672
IS - 8
M1 - 8
ER -
