Document Detail

Case-mix adjustment of consumer reports about managed behavioral health care and health plans.
MedLine Citation:
PMID:  18783456     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To develop a model for adjusting patients' reports of behavioral health care experiences on the Experience of Care and Health Outcomes (ECHO) survey to allow for fair comparisons across health plans.
DATA SOURCE: Survey responses from 4,068 individuals enrolled in 21 managed behavioral health plans who received behavioral health care within the previous year (response rate = 48 percent).
STUDY DESIGN: Potential case-mix adjustors were evaluated by combining information about their predictive power and the amount of within- and between-plan variability. Changes in plan scores and rankings due to case-mix adjustment were quantified.
PRINCIPAL FINDINGS: The final case-mix adjustment model included self-reported mental health status, self-reported general health status, alcohol/drug treatment, age, education, and race/ethnicity. The impact of adjustment on plan report scores was modest, but large enough to change some plan rankings.
CONCLUSIONS: Adjusting plan report scores on the ECHO survey for differences in patient characteristics had modest effects, but still may be important to maintain the credibility of patient reports as a quality metric. Differences between those with self-reported fair/poor health compared with those in excellent/very good health varied by plan, suggesting quality differences associated with health status and underscoring the importance of collecting quality information.
Laura L Eselius; Paul D Cleary; Alan M Zaslavsky; Haiden A Huskamp; Susan H Busch
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2008-09-08
Journal Detail:
Title:  Health services research     Volume:  43     ISSN:  1475-6773     ISO Abbreviation:  Health Serv Res     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-01-26     Completed Date:  2009-02-12     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  0053006     Medline TA:  Health Serv Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2014-32     Citation Subset:  IM    
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MeSH Terms
Behavioral Medicine*
Consumer Satisfaction*
Health Care Surveys
Health Maintenance Organizations*
Middle Aged
Quality of Health Care
Risk Adjustment*
United States
Young Adult
Grant Support
K01 MH066109/MH/NIMH NIH HHS; K01 MH066109-01/MH/NIMH NIH HHS; K01 MH66109/MH/NIMH NIH HHS; T-32 MH19733/MH/NIMH NIH HHS; T32 MH019733/MH/NIMH NIH HHS; T32 MH019733-05/MH/NIMH NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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