Abstract
Accountability, cost effectiveness, and continuous quality improvement are essential features of all managed health care systems. However, application of these principles to mental health treatments has lagged behind other health care services. In this article, administrative, practice, and technical issues are addressed through a joint effort between academically based researchers and administrators from two large managed health care organizations. Principles related to the measurement of outcome, instrument selection, and obstacles to the implementation of an ongoing program to assess mental health treatment outcomes are identified. Finally, principles for successfully changing mental health provider behavior toward outcome assessment and the implications of such for mental health delivery systems are discussed.
Similar content being viewed by others
References
Health Care Financial Administrative, HCFA Review. Washington, DC: U.S. Department of Health and Human Services, 1992.
Survey of Current Business. Washington, DC: U.S. Department of Commerce, 1992.
Wallace C: Employers turning to managed care to control costs.Modern Healthcare 1987; 41:349–360.
Cummings NA: The future of psychotherapy: One psychologist's perspective.American Journal of Psychotherapy 1987; 41:349–360.
Broskowski A: Current mental health care environments: Why managed care is necessary.Professional Psychology: Research and Practice 1991; 22:6–14.
Mirin S, Namerow M: Why study treatment outcome?Hospital and Community Psychiatry 1991; 42: 1007–1013.
Linder JC: Outcome measurement: Compliance tool or strategic initiative?Health Care Management Review 1991; 16:21–33.
Vermillion J, Pfeiffer S: Treatment outcome and continuous quality improvement: Two aspects of program evaluation.Psychiatric Hospital 1993; 24:9–14.
Dewan NA: Medical informatics and psychiatry: An issue of need.Psychiatric Times 1993; (January).
Moses-Zirkes S: Outcome research: Everybody wants it.American Psychological Association Monitor 1993; (March):22–23.
Survey on Outcome Management, 1993. Princeton, NJ: Foster, Higgins, 1994.
Davis C: Forming, storming, norming, and performing with CQI.Administrative Radiology 1994; (May):21–26.
Froyd JI, Lambert MJ: Survey and critique of psychotherapy outcome measurement.Psychotherapy Research. In press.
Lambert MJ, Ogles BM, Masters KS: Choosing outcome assessment devices: An organized and conceptual scheme.Journal of Counseling and Development 1992; 70:527–532.
Waskow I, Parloff M (Eds.):Psychotherapy Change Measures. DHEW Publication No. (ADM) 74-120. Washington, DC: U.S. Department of Health, Education, and Welfare, 1975.
Kendall PC, Norton-Ford JD: Therapy outcome research methods. In: Kendall PC, Butcher JN (Eds.):The Handbook of Research Methods in Clinical Psychology. New York: Wiley, 1982, pp. 429–460.
Horowitz L, Lambert MJ, Strupp HH:Report on the Core Battery Conference: Vanderbilt University, March, 1994. Washington, DC: American Psychological Association Press, 1994.
Lambert MJ, Hill CE: Assessing psychotherapy outcomes and processes.Handbook of Psychotherapy and Behavior Change. Fourth ed. New York: Wiley, 1994.
Iezzoni LI, Greenberg LG: Widespread assessment of risk-adjusted outcomes: Lessons from local initiative.Journal of Quality Improvement 1994; 20:305–316.
Konowe LS, Chung RS: Provider and client mental health care outcome expectations: Results of a survey and commentary on reducing dissonance through training for managed care.Journal of American Association of Preferred Provider Organizations 1994; 4:13–21.
Rush, JA: Depression guideline panel of the agency for health care policy and research: Synopsis of clinical practice guidelines for the diagnosis and treatment of depression in primary care.Archives of Family Medicine 1994; 3:13–21.
Ludden J, Mandell L: Quality planning for mental health.Journal of Mental Health Administration 1993; 20:72–78.
Herron WG, Eisenstadt EN, Javier RA, et al.: Session effects, comparability and managed care in the psychotherapies.Psychotherapy 1994; 31:279–285.
Lambert MJ, Lunnen K, Umpress V, et al.:Manual for the Outcome Questionnaire. Salt Lake City, UT: Behavioral Health Care Efficacy, 1994.
Lambert MJ:Introduction to assessment of psychotherapy outcome: Historical perspective and current issues. In: Lambert MJ, Christensen ER, DeJulio SS (Eds.),The Assessment of Psychotherapy Outcome. New York: Wiley, 1983, pp. 72–113.
Kessler RC: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States.Archives of General Psychiatry 1994; 51:8–19.
Reiger DA, Boyd JH, Burke JD, et al.: One month prevalence of mental disorders in the United States.Archives of General Psychiatry 1988; 45:977–986.
Feldman LA: Distinguishing depression and anxiety in self-report: Evidence from confirmatory factor analysis on clinical and non-clinical samples.Journal of Consulting and Clinical Psychiatry 1993; 61:631–638.
Andrews FM, Withey SB: Developing measures of perceived life quality: Results from several national surveys.Social Indicators Research 1974; 1:1–26.
Beiser M: Components and correlates of mental well-being.Journal of Health and Social Behavior 1973; 15: 320–327.
Blau TH: Quality of life, social interaction, and criteria, of change.Professional Psychology 1977; 8: 464–473.
Deiner E: Subjective well-being.Psychological Bulletin 1984; 95:195–209.
Veit CT, Ware JE: The structure of psychological distress and well-being in general populations.Journal of Consulting and Clinical Psychology 1983; 51:730–742.
Horowitz LM: On the cognitive structure of interpersonal problems treated in psychotherapy.Journal of Consulting and Clinical Psychology 1979; 47:5–15.
Horowitz LM, Rosenberg SE, Baer BA, et al.: Inventory of interpersonal problems: Psychometric properties and clinical applications.Journal of Consulting and Clinical Psychology 1988; 56:885–892.
Frisch MB, Cornell J, Villanueva M, et al.: Clinical validation of the quality of life inventory: A measure of life satisfaction for use in treatment planning and outcome assessment.Psychological Assessment 1992; 4:92–101.
Weissman MM, Bothwell S: Assessment of social adjustment by patient self-report.Archives of General Psychiatry 1976; 33:1111–1115.
Cronbach, LJ: Coefficient alpha and the internal structure of tests.Psychometrica 1951; 16:297–334.
Cohen J, Cohen P:Applied Multiple Regression/Correlation for the Behavioral Sciences. Second ed. Hillsdale, NJ: Lawrence Erlbaum.
Freeman MP: The rate of adoption of new procedures among physicians.Medical Care 1985; 23:939–945.
Jacoby I, Rose M: Transfer of information and its impact on medical practice: The U.S. experience.International Journal of Technology Assessment in Health Care 1986; 2:107–115.
Lomas J, Enkin M, Anderson GM, et al.: Opinion leaders versus audit and feedback to implement practice guidelines: Delivery after previous cesarean section.Journal of the American Medical Association 1991; 256:2202–2207.
Kosecoff J, Kanoose D, Rogers W, et al.: Effects of the National Institutes of Health consensus development program on clinical practice.Journal of the American Medical Association 1987; 258:2708–2713.
Winickoff RN, Coltrin KL, Morgan MM, et al.: Improving physician performance through peer comparison feedback.Medical Care 1984; 22:527–534.
Pugh J, Frazier L, DeLong E, et al.: Effect of daily charge feedback on inpatient charges and physician knowledge and behavior.Archives of Internal Medicine 1989; 149:426–429.
Shroeder SA: Strategies for reducing medical costs by changing physicians' behavior: Efficacy and impact on quality of care.International Journal of Technology Assessment in Health Care 1987; 3:39–50.
Eagel KA, Molley AG, Skates SJ, et al.: Length of stay in intensive care unit: Effects of practice guidelines and feedback.Journal of the American Medical Association 1990; 264:992–997.
Eisenberg JM, Williams SV: Cost containment and changing physicians' practice behavior: Can the fox learn to guard the chicken coop.Journal of the American Medical Association 1980; 246:2195–2201.
Lomas J: Words without action? The production, the dissemination, and the impact of consensus recommendations.Annual Review of Public Health 1991; 12:41–65.
McCormick B: Can research change the way MD's practice medicine?Hospitals 1990; 64:32–37.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Burlingame, G.M., Lambert, M.J., Reisinger, C.W. et al. Pragmatics of tracking mental health outcomes in a managed care setting. The Journal of Mental Health Administration 22, 226–236 (1995). https://doi.org/10.1007/BF02521118
Issue Date:
DOI: https://doi.org/10.1007/BF02521118