Decision support systems for assessing integrated mental health care: the refinement toolkit

Abstract

This symposium aims to present three mental health system evaluation tools which were developed for the Refinement project. The REFINEMENT (REsearch on FINancing systems’ Effect on the quality of MENTal health care) project had the purpose to study the relationship between different European models of health care financing and the extent to which mental health care services meet the goals of high quality, equity, efficiency and better long term health outcomes. This project was financed for 3 years by the European Commission within the 7th Framework Programme from 2011 to 2013.The Refinement project researchers used these tools in order to analyze eight European countries with very different stages in the development of mental health care, considering different balances between community and institutional care: Austria, England, Finland, France, Italy, Norway, Romania and Spain. This symposium will include results of the analysis carried out in these countries. This tool set provides useful and essential knowledge for the evidence–informed mental health planning and policy making in Europe.Describing and mapping the mental health services: THE REFINEMENT MAPPING SERVICES TOOLKIT (REMAST)The REMAST/DESDE-LTC tool aims at analyzing the spatial dimension of mental health care delivered by health and social services by means of Geographical Information System (GIS). The REMAST includes the standardized description of mental health care through the DESDE-LTC; a Service Inventory to collect complementary information; a detailed description about policies, plans and structural organizations of different mental health care services; and the Verona SES Index to describe the areas socio-economically. All data collected is utilized for the creation of specific maps in order to describe the spatial context of all mapped services.The influence of provider payment mechanism on continuity and coordination of mental health care: THE FINANCING & INCENTIVE TOOLKIT (FINCENTO)The FINCENTO tool focuses on the description of financing mechanisms for mental health care, and the identification of financial incentives/disincentives in provider payment mechanisms. The tool is intended to help in examining the impact of financial incentives/disincentives for providers and users/consumers in order to explore their effects on quality of care for people with mental health needs, including the appropriateness of pathways for people with mental health problems through the specialist mental health and general health care systems.Studying the pathways of mental health care: THE REFINEMENT PATHWAYS TOOLKIT (REPATO)REPATO (REfinement PAthways Tool) is an instrument for collecting empirical knowledge on pathways of service utilisation of persons with mental health needs, including the identification and comparison of typical patterns of service use in a wide variety of health and social care systems, identifying factors that possibly influence these patterns of service use, and assessing whether the identified pathways conform to quality of care in terms of continuity of care. REPATO consist of three main parts: (1) service utilisation patterns within primary care, and also between primary care and specialist mental health care, (2) continuity of mental health care and (3) readmission following acute psychiatric hospitalisation. Understanding the pathways of care that individuals follow within a mental health system can support the understanding of impact of different financial incentives and disincentives, as well as of issues around continuity of care.