scholarly journals Do care plans and annual reviews of physical health influence unplanned hospital utilisation for people with serious mental illness? Analysis of linked longitudinal primary and secondary healthcare records in England

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023135 ◽  
Author(s):  
Jemimah Ride ◽  
Panagiotis Kasteridis ◽  
Nils Gutacker ◽  
Christoph Kronenberg ◽  
Tim Doran ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Care Quality ◽  
Care Plan ◽  
Care Plans ◽  
Primary Care Quality ◽  
Hospital Utilisation ◽  
Reduced Risk

ObjectiveTo investigate whether two primary care activities that are framed as indicators of primary care quality (comprehensive care plans and annual reviews of physical health) influence unplanned utilisation of hospital services for people with serious mental illness (SMI).Design, setting, participantsRetrospective observational cohort study using linked primary care and hospital records (Hospital Episode Statistics) for 5158 patients diagnosed with SMI between April 2006 and March 2014, who attended 213 primary care practices in England that contribute to the Clinical Practice Research Datalink GOLD database.Outcomes and analysisCox survival models were used to estimate the associations between two primary care quality indicators (care plans and annual reviews of physical health) and the hazards of three types of unplanned hospital utilisation: presentation to accident and emergency departments (A&E), admission for SMI and admission for ambulatory care sensitive conditions (ACSC).ResultsRisk of A&E presentation was 13% lower (HR 0.87, 95% CI 0.77 to 0.98) and risk of admission to hospital for ACSC was 23% lower (HR 0.77, 95% CI 0.60 to 0.99) for patients with a care plan documented in the previous year compared with those without a care plan. Risk of A&E presentation was 19% lower for those who had a care plan documented earlier but not updated in the previous year (HR: 0.81, 95% CI 0.67 to 0.97) compared with those without a care plan. Risks of hospital admission for SMI were not associated with care plans, and none of the outcomes were associated with annual reviews.ConclusionsCare plans documented in primary care for people with SMI are associated with reduced risk of A&E attendance and reduced risk of unplanned admission to hospital for physical health problems, but not with risk of admission for mental health problems. Annual reviews of physical health are not associated with risk of unplanned hospital utilisation.

scholarly journals Identifying primary care quality indicators for people with serious mental illness: a systematic review

2017 ◽  
Vol 67 (661) ◽  
pp. e519-e530 ◽  
Author(s):  
Christoph Kronenberg ◽  
Tim Doran ◽  
Maria Goddard ◽  
Tony Kendrick ◽  
Simon Gilbody ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Quality Indicators ◽  
Serious Mental Illness ◽  
Quality Indicator ◽  
Routine Data ◽  
Care Quality ◽  
Physical And Mental Health ◽  
Long Term Conditions ◽  
Primary Care Quality

BackgroundSerious mental illness (SMI) — which comprises long-term conditions such as schizophrenia, bipolar disorder, and other psychoses — has enormous costs for patients and society. In many countries, people with SMI are treated solely in primary care, and have particular needs for physical care.AimThe objective of this study was to systematically review the literature to create a list of quality indicators relevant to patients with SMI that could be captured using routine data, and which could be used to monitor or incentivise better-quality primary care.Design and settingA systematic literature review, combined with a search of quality indicator databases and guidelines.MethodThe authors assessed whether indicators could be measured from routine data and the quality of the evidence.ResultsOut of 1847 papers and quality indicator databases identified, 27 were included, from which 59 quality indicators were identified, covering six domains. Of the 59 indicators, 52 could be assessed using routine data. The evidence base underpinning these indicators was relatively weak, and was primarily based on expert opinion rather than trial evidence.ConclusionWith appropriate adaptation for different contexts, and in line with the relative responsibilities of primary and secondary care, use of the quality indicators has the potential to improve care and to improve the physical and mental health of people with SMI. However, before the indicators can be used to monitor or incentivise primary care quality, more robust links need to be established, with improved patient outcomes.

Midwest Docs Draft Plan For Primary Care Quality

2011 ◽  
Vol 41 (19) ◽  
pp. 48-49
Author(s):  
MARY ELLEN SCHNEIDER
Keyword(s):  
Primary Care ◽  
Care Quality ◽  
Primary Care Quality

Electronic medical records and primary care quality: Evidence from Manitoba

2021 ◽  
Vol 30 (5) ◽  
pp. 1124-1138
Author(s):  
Elisabet Rodriguez Llorian ◽  
Gregory Mason
Keyword(s):  
Primary Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Care Quality ◽  
Primary Care Quality ◽  
Quality Evidence

scholarly journals Challenges of using asthma admission rates as a measure of primary care quality in children: An international comparison

2021 ◽  
pp. 135581962110127
Author(s):  
Irina Lut ◽  
Kate Lewis ◽  
Linda Wijlaars ◽  
Ruth Gilbert ◽  
Tiffany Fitzpatrick ◽  
...  
Keyword(s):  
Primary Care ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Underlying Disease ◽  
Primary Diagnosis ◽  
Care Quality ◽  
Attendance Rates ◽  
Admission Rates ◽  
Primary Care Quality ◽  
Hospital Administrative

Objectives To demonstrate the challenges of interpreting cross-country comparisons of paediatric asthma hospital admission rates as an indicator of primary care quality. Methods We used hospital administrative data from >10 million children aged 6–15 years, resident in Austria, England, Finland, Iceland, Ontario (Canada), Sweden or Victoria (Australia) between 2008 and 2015. Asthma hospital admission and emergency department (ED) attendance rates were compared between countries using Poisson regression models, adjusted for age and sex. Results Hospital admission rates for asthma per 1000 child-years varied eight-fold across jurisdictions. Admission rates were 3.5 times higher when admissions with asthma recorded as any diagnosis were considered, compared with admissions with asthma as the primary diagnosis. Iceland had the lowest asthma admission rates; however, when ED attendance rates were considered, Sweden had the lowest rate of asthma hospital contacts. Conclusions The large variations in childhood hospital admission rates for asthma based on the whole child population reflect differing definitions, admission thresholds and underlying disease prevalence rather than primary care quality. Asthma hospital admissions among children diagnosed with asthma is a more meaningful indicator for inter-country comparisons of primary care quality.

scholarly journals Effect of Enhanced Primary Care for People with Serious Mental Illness on Service Use and Screening

2021 ◽  
Author(s):  
Lexie R. Grove ◽  
Alex K. Gertner ◽  
Karen E. Swietek ◽  
Ching-Ching Claire Lin ◽  
Neepa Ray ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Service Use

Effects of Social Networks on Physical Health Among People with Serious Mental Illness

2014 ◽  
Vol 85 (4) ◽  
pp. 453-465 ◽  
Author(s):  
Sungkyu Lee ◽  
Yin-Ling Irene Wong ◽  
Aileen Rothbard
Keyword(s):  
Social Networks ◽  
Mental Illness ◽  
Physical Health ◽  
Serious Mental Illness
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