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Outcome-based providing and commissioning: pathways and standards.

David Kingdon1

  • 1University of Southampton.

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|June 11, 2019
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This study implemented evidence-based mental health care pathways, improving patient assessment and outcome tracking. Clinicians now use standardized measures to guide practice and enhance service delivery for better mental health outcomes.

Keywords:
Cost-effectivenesseconomicsinformation technologiesoutcome studiespsychosocial interventions

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Area of Science:

  • Health Services Research
  • Clinical Psychology
  • Psychiatry

Background:

  • Evidence-based psychosocial interventions are crucial for mental health care.
  • Implementation of National Institute of Health and Care Excellence (NICE) guidelines has been inconsistent.
  • A need exists for standardized assessment and outcome measurement in mental health services.

Purpose of the Study:

  • To implement and evaluate a system for allocating mental health patients to guideline-based care pathways.
  • To assess the completion rates of clinician- and patient-rated outcome measures.
  • To evaluate the adherence to clinical standards within mental health services.

Main Methods:

  • Adult patients in mental health services were allocated to six guideline categories.
  • Clinician- and patient-rated outcome measures, including the Health of the Nation Outcome Scales and DIALOG, were utilized.
  • Individual patient assessments were conducted against established clinical standards.

Main Results:

  • Over 5000 patients were allocated to pathways within the first 3 months.
  • 73% of patients were assessed against at least one clinical standard.
  • High completion rates were observed for the Health of the Nation Outcome Scales (91-93%), with 36% completing the DIALOG measure.

Conclusions:

  • The implemented system facilitates pathway allocation, outcome measurement, and standard assessment.
  • This approach provides valuable data for guiding clinical practice, service design, and mental health system costing.
  • Technology-assisted data entry and presentation can significantly improve information accessibility for patients and clinicians, potentially enabling outcome-based payment models.