Improving Quality of Mental Health Care: An Evaluation of Process and Outcome Measures in Patients Diagnosed with Schizophrenia

Carmela J. Benson, Jefferson School of Population Health, Thomas Jefferson University

Advisor: Drew Harris, DPM, MPH

Jefferson School of Population Health, Thomas Jefferson University


The overall cost associated in treating schizophrenia is high but the quality of care is poor. Compared to other chronic conditions, quality metrics in schizophrenia are limited. To improve quality care in schizophrenia, more effort is needed to collect and measure data on quality. The purpose of the current study is to measure and describe the quality of care in schizophrenia patients, examine quality of care associations to healthcare coverage, healthcare resource utilization, and patient outcomes. The data source for this project was the Research and Evaluation of Antipsychotic Treatment in Community Behavioral Organizations OUTComes (REACH OUT) program, a naturalistic, longitudinal study of adult patients with schizophrenia or bipolar I disorder receiving their primary treatment at community behavioral health organizations (CBHOs). Data collected at baseline were used to measure and evaluate quality of care from five dimensions: clinical care, patient experience, care coordination, population health and patient safety. Only 8% of the study sample attained all five quality measures, and 28% potentially received low to poor quality care. Care coordination appeared to be low. Patient safety was significantly associated with patient experience (p<.0001), and with the quality domain of population health (p<.0001). A significant association was observed between care quality and health insurance coverage (p<.0001). Measuring healthcare quality in schizophrenia is a challenge in the absence of endorsed measures. Overall, care quality at CBHOs is positively influenced by access and frequency of services or treatment. ACA 2010 can positively impact patient outcomes and care quality through expansion and modification of insurance coverage.

Presentation: 32 minutes