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Quality of public sector care for schizophrenia in Arkansas.

Fischer EP, Owen RR. Quality of public sector care for schizophrenia in Arkansas. Mental health services research. 1999 Dec 1; 1(4):213-21.

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Abstract:

OBJECTIVE: Using process-of-care indicators, we examined the quality of care provided to 139 individuals receiving treatment for schizophrenia in public sector systems. METHODS: Longitudinal data on services use and medication management were abstracted from medical records. Medication adherence data were obtained by self- and informant reports. RESULTS: Overall, 39% of participants had less than monthly contact with community-based service (CBS) providers. When participants in day treatment or partial hospitalization programs were excluded, less than monthly CBS contact increased to 70%. Of participants, 40%-60% were prescribed medications outside guideline-recommended dose ranges. Up to half of participants reported taking half or less of prescribed antipsychotics. The adverse impact on patient outcomes of these practice patterns is well established. CONCLUSIONS: Public sector organizations face powerful challenges to the behavioral changes needed to sustain best practice care. Overcoming these challenges to assure high-quality care for schizophrenia will require tremendous creativity and commitment.




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