"INTERMED": a method to assess health service needs. I. Development and reliability

Area of Science:

• Health Services Research
• Psychiatry
• Internal Medicine

Background:

• Assessing patient health service needs requires methods that integrate biopsychosocial aspects.
• Existing methods may not adequately address case complexity or facilitate interdisciplinary communication.

Purpose of the Study:

• To develop and test the reliability of the INTERMED method for health service needs assessment.
• To enhance interdisciplinary communication among healthcare professionals.
• To provide a tool for describing case complexity for clinical, scientific, and educational purposes.

Main Methods:

• Development of the INTERMED instrument integrating biopsychosocial factors and patient-healthcare system relationships.
• Feasibility study with 21 patients.
• Two interrater reliability studies involving joint interviews and separate chart reviews by multiple clinicians.
• Analysis of scoring agreement and identification of areas for improvement.

Main Results:

• Averaged across two studies, 94.2% of ratings showed no significant difference between raters.
• The INTERMED method demonstrated good reliability, particularly when used by experienced raters via patient interviews.
• Study 2 indicated lower agreement when raters were less experienced or relied solely on medical charts.

Conclusions:

• The INTERMED is a reliable and time-efficient tool for classifying patient care needs and assessing case complexity.
• It effectively supports interdisciplinary communication and can aid in evaluating the interface between general and mental healthcare services.
• Further refinements to the INTERMED, particularly anchor points, can enhance interrater reliability in diverse clinical settings.