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Improving access to services for psychotic patients: does implementing a waiting time target make a difference.

Anika Kreutzberg1, Rowena Jacobs2

  • 1Department of Health Care Management, Technical University of Berlin, Strasse des 17. Juni 135, 10623, Berlin, Germany. anika.kreutzberg@tu-berlin.de.

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PubMed
Summary

The 14-day waiting time target for early intervention in psychosis (EIP) services increased the likelihood of patients meeting the goal. However, this did not improve overall waiting times across all patient groups.

Keywords:
Difference-in-difference analysisEarly intervention in psychosisMental healthWaiting time targets

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Area of Science:

  • Mental Health Services Research
  • Health Policy Analysis
  • Psychosis Treatment Outcomes

Background:

  • The English National Health Service introduced waiting time targets for mental health care in April 2015.
  • This study focuses on the initial six months post-implementation of the 14-day target for early intervention in psychosis (EIP) services.

Purpose of the Study:

  • To evaluate the impact of the 14-day waiting time target on EIP services.
  • To assess whether the target influenced waiting times for first-episode psychosis patients.

Main Methods:

  • Analysis of a cohort of first-episode psychosis patients (2011-2015) from the Mental Health and Learning Disabilities Dataset.
  • Comparison of patients in EIP services (treatment group) versus standard community mental health services (control group).
  • Utilized non-parametric matching and difference-in-difference methods to control for patient and service characteristics.

Main Results:

  • Patients receiving EIP services showed an 11.6-18.4 percentage point higher probability of waiting under the target compared to controls post-policy.
  • No significant differences in waiting time trends were observed across different percentiles of the waiting time distribution between EIP and standard care patients.

Conclusions:

  • Mental health providers appear to adapt to waiting time targets similarly to physical health providers.
  • While the proportion of patients meeting the target increased, this did not translate to a broader improvement in waiting time distribution for psychosis care.