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Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services
BACKGROUND: Italy can be viewed as a laboratory to assess the quality of mental healthcare delivered in a community-oriented system, especially for severe mental disorders, such as personality disorders. Although initiatives based on clinical indicators for assessing the quality of mental healthcare...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10571410/ https://www.ncbi.nlm.nih.gov/pubmed/37833745 http://dx.doi.org/10.1186/s13033-023-00603-9 |
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author | Sanza, Michele Monzio Compagnoni, Matteo Caggiu, Giulia Allevi, Liliana Barbato, Angelo Campa, Jeannette Carle, Flavia D’avanzo, Barbara Di Fiandra, Teresa Ferrara, Lucia Gaddini, Andrea Saponaro, Alessio Scondotto, Salvatore Tozzi, Valeria D Lorusso, Stefano Giordani, Cristina Corrao, Giovanni Lora, Antonio |
author_facet | Sanza, Michele Monzio Compagnoni, Matteo Caggiu, Giulia Allevi, Liliana Barbato, Angelo Campa, Jeannette Carle, Flavia D’avanzo, Barbara Di Fiandra, Teresa Ferrara, Lucia Gaddini, Andrea Saponaro, Alessio Scondotto, Salvatore Tozzi, Valeria D Lorusso, Stefano Giordani, Cristina Corrao, Giovanni Lora, Antonio |
author_sort | Sanza, Michele |
collection | PubMed |
description | BACKGROUND: Italy can be viewed as a laboratory to assess the quality of mental healthcare delivered in a community-oriented system, especially for severe mental disorders, such as personality disorders. Although initiatives based on clinical indicators for assessing the quality of mental healthcare have been developed by transnational-organisations, there is still no widespread practice of measuring the quality of care pathways delivered to patients with severe mental disorders in a community-oriented system, especially using administrative healthcare databases. The aim of the study is to evaluate the quality of care delivered to patients with personality disorders taken-in-care by mental health services of four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). METHODS: A set of thirty-three clinical indicators, concerning accessibility, appropriateness, continuity, and safety of care, was implemented using regional healthcare utilization databases, containing data on mental health treatments and diagnosis, hospital admissions, outpatient interventions and exams and drug prescriptions. RESULTS: 31,688 prevalent patients with personality disorders treated in 2015 were identified, of whom 2,331 newly taken-in-care. One-in-10 patients received a standardized assessment, the treatment discontinuity affected half of the cases. 12.7% of prevalent patients received at least one hospitalization, 10.6% in the newly taken-in-care cohort. 6-out-of-10 patients had contact with community-services within 14 days from hospital discharge. Access to psychotherapy and psychoeducational treatments was low and delivered with a low intensity. The median of psychosocial interventions per person-year was 19.1 and 9.4, respectively, in prevalent and newly taken-in-care cases. Nearly 50% of patients received pharmacological treatments. CONCLUSIONS: Healthcare utilization databases were used to systematically evaluate and assess service delivery across regional mental health systems; suggesting that in Italy the public mental health services provide to individuals with personality disorders suboptimal treatment paths. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13033-023-00603-9. |
format | Online Article Text |
id | pubmed-10571410 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105714102023-10-14 Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services Sanza, Michele Monzio Compagnoni, Matteo Caggiu, Giulia Allevi, Liliana Barbato, Angelo Campa, Jeannette Carle, Flavia D’avanzo, Barbara Di Fiandra, Teresa Ferrara, Lucia Gaddini, Andrea Saponaro, Alessio Scondotto, Salvatore Tozzi, Valeria D Lorusso, Stefano Giordani, Cristina Corrao, Giovanni Lora, Antonio Int J Ment Health Syst Research BACKGROUND: Italy can be viewed as a laboratory to assess the quality of mental healthcare delivered in a community-oriented system, especially for severe mental disorders, such as personality disorders. Although initiatives based on clinical indicators for assessing the quality of mental healthcare have been developed by transnational-organisations, there is still no widespread practice of measuring the quality of care pathways delivered to patients with severe mental disorders in a community-oriented system, especially using administrative healthcare databases. The aim of the study is to evaluate the quality of care delivered to patients with personality disorders taken-in-care by mental health services of four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). METHODS: A set of thirty-three clinical indicators, concerning accessibility, appropriateness, continuity, and safety of care, was implemented using regional healthcare utilization databases, containing data on mental health treatments and diagnosis, hospital admissions, outpatient interventions and exams and drug prescriptions. RESULTS: 31,688 prevalent patients with personality disorders treated in 2015 were identified, of whom 2,331 newly taken-in-care. One-in-10 patients received a standardized assessment, the treatment discontinuity affected half of the cases. 12.7% of prevalent patients received at least one hospitalization, 10.6% in the newly taken-in-care cohort. 6-out-of-10 patients had contact with community-services within 14 days from hospital discharge. Access to psychotherapy and psychoeducational treatments was low and delivered with a low intensity. The median of psychosocial interventions per person-year was 19.1 and 9.4, respectively, in prevalent and newly taken-in-care cases. Nearly 50% of patients received pharmacological treatments. CONCLUSIONS: Healthcare utilization databases were used to systematically evaluate and assess service delivery across regional mental health systems; suggesting that in Italy the public mental health services provide to individuals with personality disorders suboptimal treatment paths. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13033-023-00603-9. BioMed Central 2023-10-13 /pmc/articles/PMC10571410/ /pubmed/37833745 http://dx.doi.org/10.1186/s13033-023-00603-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Sanza, Michele Monzio Compagnoni, Matteo Caggiu, Giulia Allevi, Liliana Barbato, Angelo Campa, Jeannette Carle, Flavia D’avanzo, Barbara Di Fiandra, Teresa Ferrara, Lucia Gaddini, Andrea Saponaro, Alessio Scondotto, Salvatore Tozzi, Valeria D Lorusso, Stefano Giordani, Cristina Corrao, Giovanni Lora, Antonio Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services |
title | Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services |
title_full | Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services |
title_fullStr | Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services |
title_full_unstemmed | Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services |
title_short | Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services |
title_sort | assessing the quality of the care offer for people with personality disorders in italy: the quadim project. a multicentre research based on the database of use of mental health services |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10571410/ https://www.ncbi.nlm.nih.gov/pubmed/37833745 http://dx.doi.org/10.1186/s13033-023-00603-9 |
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