Quality assessment of primary care for common mental disorders in isolated communities: Taking advantage of health records

Lily Lessard,Diane Morin,Louise Fournier,Josée Gauthier

doi:10.22605/rrh3224

Abstract

This article is part of a research study on the organization of primary health care (PHC) for mental health in two of Quebec's remote regions. It introduces a methodological approach based on information found in health records, for assessing the quality of PHC offered to people suffering from depression or anxiety disorders. Quality indicators were identified from evidence and case studies were reconstructed using data collected in health records over a 2-year observation period. Data collection was developed using a three-step iterative process: (1) feasibility analysis, (2) development of a data collection tool, and (3) application of the data collection method. The adaptation of quality-of-care indicators to remote regions was appraised according to their relevance, measurability and construct validity in this context. As a result of this process, 18 quality indicators were shown to be relevant, measurable and valid for establishing a critical quality appraisal of four recommended dimensions of PHC clinical processes: recognition, assessment, treatment and follow-up. There is not only an interest in the use of health records to assess the quality of PHC for mental health in remote regions but also a scientific value for the rigorous and meticulous methodological approach developed in this study. From the perspective of stakeholders in the PHC system of care in remote areas, quality indicators are credible and provide potential for transferability to other contexts. This study brings information that has the potential to identify gaps in and implement solutions adapted to the context.

Highlights

This article is part of a research study on the organization of primary health care (PHC) for mental health in two of Quebec’s remote regions
This study aimed to better support local and regional stakeholders in their efforts to improve their population’s access to quality mental health services by addressing the research question, ‘Are health records a valuable source for assessing quality of PHC offered to individuals with common mental disorders who live in Quebec’s isolated rural communities?’ The goal was to identify useful, measurable and valid indicators[12,24,25,29] adapted to the context of health services in isolated rural communities and that could be measured from information found in health records
A total of 36 quality indicators for clinical procedures that could be adapted to isolated rural communities were initially selected after reviewing relevant practice guidelines for depression and anxiety disorders[40,41] and using indicators from the NINHQM20

Summary

Introduction

This article is part of a research study on the organization of primary health care (PHC) for mental health in two of Quebec’s remote regions. It introduces a methodological approach based on information found in health records, for assessing the quality of PHC offered to people suffering from depression or anxiety disorders. Researchers worked in collaboration with decisionmakers involved in two isolated regions of Quebec to adapt procedures and research tools so as to provide them with a way to assess the quality of PHC offered within their populations to those with various mental health-related needs. This article focuses mainly on the methodology developed for assessing PHC quality associated with common mental disorders, such as depression and anxiety disorders

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Conclusion