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Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana – structural equation modelling.
INTRODUCTION: Incorporating consumers’ perspectives into the quality of mental health service measurement is a growing priority among mental health professionals’ and policymakers. Despite this, there is limited empirical evidence related to consumer perspectives of quality of mental health services...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244180/ https://www.ncbi.nlm.nih.gov/pubmed/32442192 http://dx.doi.org/10.1371/journal.pone.0233351 |
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author | Badu, Eric O’Brien, Anthony Paul Mitchell, Rebecca Osei, Akwasi |
author_facet | Badu, Eric O’Brien, Anthony Paul Mitchell, Rebecca Osei, Akwasi |
author_sort | Badu, Eric |
collection | PubMed |
description | INTRODUCTION: Incorporating consumers’ perspectives into the quality of mental health service measurement is a growing priority among mental health professionals’ and policymakers. Despite this, there is limited empirical evidence related to consumer perspectives of quality of mental health services. This study, therefore, aims to measure the mediation and moderation effects of health system structure and process on mental health quality in Ghana. METHODS: A random sample of 510 consumers were recruited to complete the Verona Satisfaction Scale (54-items), together with the WHO Disability Assessment Instrument (36 items) using the Redcap application. Confirmatory factor analysis (CFA) and Structural Equation Modelling were used to test the hypothesised theory using STATA 15. RESULTS: The CFA showed that the hypothesised model had a good fit to the data. The findings confirmed the hypothesis that the process constructs mediate the relationship between the health system structure and the outcome of mental health services. Specifically, the health system structure had a positive and significant causal relationship with the mediator-process (β = 0.60; p<0.01) and outcome (β = 0.47; p<0.01). Additionally, the mediator-process had a positive causal relationship with the outcome of the mental health services (β = 0.32; p<0.01). Insurance status (β = 0.07; p>0.05) and type of services (β = 0.025; p>0.05) had a positive moderating effect on the relationship between health system structure and outcome but were not significant. CONCLUSION: Improvements to mental health system structure and the process could promote the quality of services as experienced by consumers. Government stakeholders are encouraged to accordingly strengthen health systems with the aim of improving the mental health outcomes for consumers. |
format | Online Article Text |
id | pubmed-7244180 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-72441802020-06-05 Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana – structural equation modelling. Badu, Eric O’Brien, Anthony Paul Mitchell, Rebecca Osei, Akwasi PLoS One Research Article INTRODUCTION: Incorporating consumers’ perspectives into the quality of mental health service measurement is a growing priority among mental health professionals’ and policymakers. Despite this, there is limited empirical evidence related to consumer perspectives of quality of mental health services. This study, therefore, aims to measure the mediation and moderation effects of health system structure and process on mental health quality in Ghana. METHODS: A random sample of 510 consumers were recruited to complete the Verona Satisfaction Scale (54-items), together with the WHO Disability Assessment Instrument (36 items) using the Redcap application. Confirmatory factor analysis (CFA) and Structural Equation Modelling were used to test the hypothesised theory using STATA 15. RESULTS: The CFA showed that the hypothesised model had a good fit to the data. The findings confirmed the hypothesis that the process constructs mediate the relationship between the health system structure and the outcome of mental health services. Specifically, the health system structure had a positive and significant causal relationship with the mediator-process (β = 0.60; p<0.01) and outcome (β = 0.47; p<0.01). Additionally, the mediator-process had a positive causal relationship with the outcome of the mental health services (β = 0.32; p<0.01). Insurance status (β = 0.07; p>0.05) and type of services (β = 0.025; p>0.05) had a positive moderating effect on the relationship between health system structure and outcome but were not significant. CONCLUSION: Improvements to mental health system structure and the process could promote the quality of services as experienced by consumers. Government stakeholders are encouraged to accordingly strengthen health systems with the aim of improving the mental health outcomes for consumers. Public Library of Science 2020-05-22 /pmc/articles/PMC7244180/ /pubmed/32442192 http://dx.doi.org/10.1371/journal.pone.0233351 Text en © 2020 Badu et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Badu, Eric O’Brien, Anthony Paul Mitchell, Rebecca Osei, Akwasi Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana – structural equation modelling. |
title | Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana – structural equation modelling. |
title_full | Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana – structural equation modelling. |
title_fullStr | Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana – structural equation modelling. |
title_full_unstemmed | Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana – structural equation modelling. |
title_short | Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana – structural equation modelling. |
title_sort | mediation and moderation effects of health system structure and process on the quality of mental health services in ghana – structural equation modelling. |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244180/ https://www.ncbi.nlm.nih.gov/pubmed/32442192 http://dx.doi.org/10.1371/journal.pone.0233351 |
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