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9. The National VA Psychosis Registry: Development and Uses

Blow, FC, SMITREC/HSR&D COE, Ann Arbor; Gillon, L, SMITREC/HSR&D COE, Ann Arbor; McCarthy, J, SMITREC/HSR&D COE, Ann Arbor; Valenstein, M, SMITREC/HSR&D COE, Ann Arbor; Zeber, J, SMITREC/HSR&D COE, Ann Arbor; Bingham, R, SMITREC/HSR&D COE, Ann Arbor

Workshop Objectives: To discuss the purposes and development of the National VA Psychosis Registry. The Psychosis Registry was developed by the Serious Mental Illness Treatment, Research and Evaluation Center (SMITREC) and contains data on all patients who received a diagnosis of schizophrenia, bipolar disorder, and other psychoses (ICD-9 codes 295.x, 296.x, 297.x, and 298.x; excluding 295.5, 296.2 or 296.3) in an inpatient setting from 1988 through the present or in an outpatient setting from 1997 through the present (N=191,606).

We review the VA data sources used to create the registry and the methods used for data integration. We also describe the contents of the registry and the annual reports that will be disseminated to administrators and policy makers throughout the VA.

Several brief papers will be presented, using data from the Registry. These studies suggest several opportunities for improvement in the services offered to this vulnerable population. We discuss racial disparities in the diagnosis of schizophrenia and bipolar disorder, patient adherence with antipsychotic medications, standardized mortality ratios and risk factors for excess mortality, the impact of access to VA facilities on care processes, and systematic differences in Global Assessment of Function (GAF) ratings as a function of race/ethnicity.

Workshop Activities: The audience will participate in a discussion of the methodological issues involved in creating a registry and the potential uses of the psychosis registry. Participants will also discuss the desirability and role of registries in monitoring the care of other chronic mental or medical disorders. Suggestions will be elicited regarding additional information that would be important to disseminate to policy makers about the care of these patients.

Target Audience: The target audience includes mental health and primary care clinicians; individuals interested in establishing VA registries for other chronic medical illnesses; and mental health administrators and policy makers.

Audience Familiarity: Participants can participate on a number of levels. Individuals familiar with VA datasets may be interested in discussing techniques used for data integration. Individuals with an interest in mental health services may be interested in the preliminary findings about the care of patients with chronic mental disorders and the implications of these findings. Clinicians and policymakers will have the opportunity to give input regarding the content of future annual reports on the care of veterans with psychosis.