IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v140y2015icp127-135.html
   My bibliography  Save this article

Comparing the performance of English mental health providers in achieving patient outcomes

Author

Listed:
  • Moran, Valerie
  • Jacobs, Rowena

Abstract

Evidence on provider payment systems that incorporate patient outcomes is limited for mental health care. In England, funding for mental health care services is changing to a prospective payment system with a future objective of linking some part of provider payment to outcomes. This research examines performance of mental health providers offering hospital and community services, in order to investigate if some are delivering better outcomes. Outcomes are measured using the Health of the Nation Outcome Scales (HoNOS) – a clinician-rated routine outcome measure (CROM) mandated for national use. We use data from the Mental Health Minimum Data Set (MHMDS) – a dataset on specialist mental health care with national coverage – for the years 2011/12 and 2012/13 with a final estimation sample of 305,960 observations with follow-up HoNOS scores. A hierarchical ordered probit model is used and outcomes are risk adjusted with independent variables reflecting demographic, need, severity and social indicators. A hierarchical linear model is also estimated with the follow-up total HoNOS score as the dependent variable and the baseline total HoNOS score included as a risk-adjuster. Provider performance is captured by a random effect that is quantified using Empirical Bayes methods. We find that worse outcomes are associated with severity and better outcomes with older age and social support. After adjusting outcomes for various risk factors, variations in performance are still evident across providers. This suggests that if the intention to link some element of provider payment to outcomes becomes a reality, some providers may gain financially whilst others may lose. The paper contributes to the limited literature on risk adjustment of outcomes and performance assessment of providers in mental health in the context of prospective activity-based payment systems.

Suggested Citation

  • Moran, Valerie & Jacobs, Rowena, 2015. "Comparing the performance of English mental health providers in achieving patient outcomes," Social Science & Medicine, Elsevier, vol. 140(C), pages 127-135.
    • Handle: RePEc:eee:socmed:v:140:y:2015:i:c:p:127-135
    DOI: 10.1016/j.socscimed.2015.07.009
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953615300253
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2015.07.009?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Rowena Jacobs, 2009. "Investigating Patient Outcome Measures in Mental Health," Working Papers 048cherp, Centre for Health Economics, University of York.
    2. Anders Skrondal & Sophia Rabe‐Hesketh, 2009. "Prediction in multilevel generalized linear models," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 172(3), pages 659-687, June.
    3. Anne Mason & Maria Goddard, 2009. "Payment by results in mental health: A review of the international literature and an economic assessment of the approach in the English NHS," Working Papers 050cherp, Centre for Health Economics, University of York.
    4. Peter C. Smith & Andrew D. Street, 2013. "On The Uses Of Routine Patient‐Reported Health Outcome Data," Health Economics, John Wiley & Sons, Ltd., vol. 22(2), pages 119-131, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nils Gutacker & Chris Bojke & Silvio Daidone & Nancy Devlin & Andrew Street, 2013. "Hospital Variation in Patient-Reported Outcomes at the Level of EQ-5D Dimensions," Medical Decision Making, , vol. 33(6), pages 804-818, August.
    2. Anika Reichert & Rowena Jacobs, 2018. "The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1772-1787, November.
    3. Emilia Justyna Powell & Steven Christian McDowell & Robert O’Brien & Julia Oksasoglu, 2021. "Islam-based legal language and state governance: democracy, strength of the judiciary and human rights," Constitutional Political Economy, Springer, vol. 32(3), pages 376-412, September.
    4. Daniele Pacifico, 2013. "On the role of unobserved preference heterogeneity in discrete choice models of labour supply," Empirical Economics, Springer, vol. 45(2), pages 929-963, October.
    5. Nils Gutacker & Andrew Street, 2018. "Multidimensional performance assessment of public sector organisations using dominance criteria," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 13-27, February.
    6. Caliendo, Marco & Künn, Steffen & Uhlendorff, Arne, 2016. "Earnings exemptions for unemployed workers: The relationship between marginal employment, unemployment duration and job quality," Labour Economics, Elsevier, vol. 42(C), pages 177-193.
    7. Schurer, Stefanie & Yong, Jongsay, 2012. "Personality, well-being and the marginal utility of income: What can we learn from random coefficient models?," Working Paper Series 18617, Victoria University of Wellington, School of Economics and Finance.
    8. Steffen Nestler & Sarah Humberg, 2022. "A Lasso and a Regression Tree Mixed-Effect Model with Random Effects for the Level, the Residual Variance, and the Autocorrelation," Psychometrika, Springer;The Psychometric Society, vol. 87(2), pages 506-532, June.
    9. James J. Heckman & Ganesh Karapakula, 2019. "The Perry Preschoolers at Late Midlife: A Study in Design-Specific Inference," Working Papers 2019-034, Human Capital and Economic Opportunity Working Group.
    10. Raulinajtys-Grzybek, Monika, 2014. "Cost accounting models used for price-setting of health services: An international review," Health Policy, Elsevier, vol. 118(3), pages 341-353.
    11. repec:zbw:rwirep:0470 is not listed on IDEAS
    12. Valerie Moran & Rowena Jacobs, 2018. "Investigating the relationship between costs and outcomes for English mental health providers: a bi-variate multi-level regression analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(5), pages 709-718, June.
    13. Gerard J Van Den Berg & Barbara Hofmann & Arne Uhlendorff, 2016. "The Role of Sickness in the Evaluation of Job Search Assistance and Sanctions," Working Papers 2016-17, Center for Research in Economics and Statistics.
    14. Clara Pott & Tom Stargardt & Udo Schneider & Simon Frey, 2021. "Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 101-114, February.
    15. Laura Haas & Tom Stargardt & Jonas Schreyoegg & Rico Schlösser & Burghard Klapp & Gerhard Danzer, 2013. "The Trade-off Between Costs and Quality of Care in the Treatment of Psychosomatic Patients with Somatoform Pain Disorder," Applied Health Economics and Health Policy, Springer, vol. 11(4), pages 359-368, August.
    16. Matthew Franklin & Clara Mukuria & Brendan Mulhern & Irwin Tran & John Brazier & Stuart Watson, 2019. "Measuring the Burden of Schizophrenia Using Clinician and Patient-Reported Measures: An Exploratory Analysis of Construct Validity," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(4), pages 405-417, August.
    17. Ifigeneia Mavranezouli, 2010. "A Review and Critique of Studies Reporting Utility Values for Schizophrenia-Related Health States," PharmacoEconomics, Springer, vol. 28(12), pages 1109-1121, December.
    18. Elbers, Chris & van der Weide, Roy, 2014. "Estimation of normal mixtures in a nested error model with an application to small area estimation of poverty and inequality," Policy Research Working Paper Series 6962, The World Bank.
    19. Gutacker, Nils & Bloor, Karen & Bojke, Chris & Walshe, Kieran, 2018. "Should interventions to reduce variation in care quality target doctors or hospitals?," Health Policy, Elsevier, vol. 122(6), pages 660-666.
    20. Schurer, S. & Yong, J., 2012. "Personality, well-being and the marginal utility of income: What can we learn from random coefficient models?," Health, Econometrics and Data Group (HEDG) Working Papers 12/01, HEDG, c/o Department of Economics, University of York.
    21. repec:lic:licosd:42721 is not listed on IDEAS
    22. Rudy Douven & Minke Remmerswaal & Ilaria Mosca, 2014. "Unintended effects of reimbursement schedules in mental health care," CPB Discussion Paper 292.rdf, CPB Netherlands Bureau for Economic Policy Analysis.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:140:y:2015:i:c:p:127-135. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.