Prioritizing quality measure concepts at the interface of behavioral and physical healthcare

Harold Alan Pincus; Mingjie Li; Deborah M Scharf; Brigitta Spaeth-Rublee; Matthew L Goldman; Parashar P Ramanuj; Erin K Ferenchick

doi:10.1093/intqhc/mzx071

Prioritizing quality measure concepts at the interface of behavioral and physical healthcare

Int J Qual Health Care. 2017 Aug 1;29(4):557-563. doi: 10.1093/intqhc/mzx071.

Authors

Harold Alan Pincus^{1

2}, Mingjie Li³, Deborah M Scharf⁴, Brigitta Spaeth-Rublee³, Matthew L Goldman^{3

5}, Parashar P Ramanuj⁶, Erin K Ferenchick⁷

Affiliations

¹ Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 09, New York, NY 10032, USA.
² New York-Presbyterian Hospital, 630 West 168th Street, New York, NY 10032, USA.
³ New York State Psychiatric Institute, 1051 Riverside Drive, Unit 9, New York, NY 10032, USA.
⁴ Department of Psychology, Lakehead University, 955 Oliver Road, Thunder Bay Ontario, P7B 5E1, Canada.
⁵ Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Box 99, New York, NY 10032, USA.
⁶ Royal National Orthopaedic Hospital, 45 Bolsover Street, London, W1W 5AQ, UK.
⁷ Center for Family and Community Medicine, Columbia University Medical Center, 610 West 158th Street, New York, NY 10032, USA.

Abstract

Objective: Integrated healthcare models can increase access to care, improve healthcare quality, and reduce cost for individuals with behavioral and general medical healthcare needs, yet there are few instruments for measuring the quality of integrated care. In this study, we identified and prioritized concepts that can represent the quality of integrated behavioral health and general medical care.

Design: We conducted a literature review to identify candidate measure concepts. Experts then participated in a modified Delphi process to prioritize the concepts for development into specific quality measures.

Setting: United States.

Participants: Expert behavioral health and general medical clinicians, decision-makers (policy, regulatory and administrative professionals) and patient advocates.

Main outcome measures: Panelists rated measure concepts on importance, validity and feasibility.

Results: The literature review identified 734 measures of behavioral or general medical care, which were then distilled into 43 measure concepts. Thirty-three measure concepts (including a segmentation strategy) reached a predetermined consensus threshold of importance, while 11 concepts did not. Two measure concepts were 'ready for further development' ('General medical screening and follow-up in behavioral health settings' and 'Mental health screening at general medical healthcare settings'). Among the 31 additional measure concepts that were rated as important, 7 were rated as valid (but not feasible), while the remaining 24 concepts were rated as neither valid nor feasible.

Conclusions: This study identified quality measure concepts that capture important aspects of integrated care. Researchers can use the prioritization process described in this study to guide healthcare quality measures development work.

Keywords: behavioral health care; general medical health care; integrated healthcare; mental health; quality measurement.

© The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

MeSH terms

Delivery of Health Care, Integrated
Delphi Technique
Humans
Mental Health Services / standards*
Outcome and Process Assessment, Health Care
Quality Indicators, Health Care / standards*
Quality of Health Care / standards
United States