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Application of a case-control design to the analysis of drop-outs from integrated behavioural health care
James E Rohrer1, Kurt B Angstman, Jennifer L Pecina
1Department of Family Medicine, Mayo Clinic, Rochester, MN, USA. rohrer.james@mayo.edu
Background:
Case-control designs are rarely employed in quality improvement investigations. The reason for the study was two-fold: (1) to demonstrate the feasibility of the method in a practice setting, and (2) because drop-outs from this programme had not previously been investigated.
Methods:
Drop-out was defined as termination due to non-contact after two consecutive months. Fifty drop-outs were randomly selected from all cases discharged from the programme during the period 1 March 2008 to 28 February 2012. Fifty controls were randomly selected from among those discharged patients who did not drop out due to non-contact.
Results:
Dropping out was significantly associated with female sex (P = 0.015), younger age (P = 0.000) and treatment site (P = 0.004). Sites still in the shake-down period had higher drop-out rates. Depression diagnosis and severity were not significant.
Conclusions:
The case-control design is an efficient approach to retrospective analysis of discrete quality indicators.
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