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HERC Health Economics Seminar

Validating and Applying VA Substance Use Disorder and Mental Health Performance Measures through Operations-Partnered Investigation

by Austin Frakt, PhD
Seminar date: 3/16/2016

Description: The QUERI/HSR&D-funded Partnered Evidence-based Policy Resource Center (PEPReC) has engaged in analysis of substance use disorder (SUD) and mental health performance measures, in partnership with the Office of Mental Health Operations (OMHO). This talk will describe the role of PEPReC in this effort and others and then summarize OMHO-related work in two areas: (1) In the 2000s, the Veterans Health Administration (VA) implemented several initiatives that increased funding for SUD treatment during a period of growth in demand for it. Using VA SUD treatment funding data and patient-level records to construct performance measures, we studied the relationship between funding and access during the expansion. Overall, we observed an increase in access to and intensity of VA SUD care associated with increased funding. The VA was able to increase funding for and expand the population to which it offered SUD treatment without diminishing internal access and intensity. (2) Satisfaction with care is an important, patient-centered domain of health system quality. We investigated the risk-adjusted association of a suite of VA mental health access and encounter satisfaction measures with a large collection of measures of program characteristics that span the domains of program reach, psychosocial service access, program intensity, and treatment continuity. We found that satisfaction with access to care was higher than with experiences with care encounters. We also found that broad measures of mental health care program reach and intensity were positively associated with both kinds of satisfaction. No measures of psychosocial service access were positively associated with both access and encounter satisfaction, which may be an artifact of the sample frame of VHA’s satisfaction data. Most strikingly, nearly all measures of treatment continuity were strongly and positively associated with both kinds of satisfaction. Target audience: VA researchers, particularly with mental health or substance use disorder foci; VA operations in those areas; others interested in the new Partnered Evidence-based Policy Resource Center (PEPReC)

DOWNLOAD: PDF handout | Audio only (mp3) | transcript

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