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

机译:确定严重精神疾病患者的初级保健质量指标:系统评价

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摘要

BackgroundSerious mental illness (SMI) — which comprises long-term conditions such asschizophrenia, 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 basedon expert opinion rather than trial evidence.ConclusionWith appropriate adaptation for different contexts, and in line with the relativeresponsibilities 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 orincentivise primary care quality, more robust links need to be established, with improved patient outcomes.
机译:背景严重的精神疾病(SMI)–包括精神分裂症,躁郁症和其他精神病等长期疾病–对患者和社会造成巨大的损失。在许多国家/地区,患有SMI的人仅接受初级保健,并且对身体护理有特殊需求。目的本研究的目的是系统地复习文献,以创建可与SMI患者相关的质量指标清单。常规数据,可用于监测或激励质量更好的初级保健。设计和设置系统的文献综述,结合对质量指标数据库和指南的搜索方法作者评估了是否可以从常规数据和质量中衡量指标结果在1847篇论文和质量指标数据库中,包括27篇论文,从中识别出59项质量指标,涵盖了六个领域。在59项指标中,有52项可以使用常规数据进行评估。这些指标所依据的证据基础相对薄弱,主要基于专家意见而不是试验证据。结论根据不同情况进行适当调整,并与初级和二级保健的相对责任相一致,使用质量指标有可能改善护理并改善SMI患者的身心健康。但是,在将这些指标用于监测或激励初级保健质量之前,需要建立更牢固的联系并改善患者的预后。

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