Quality of Somatic Care for the Seriously Mentally III

描述（由申请人提供）：这是NIMH RCA-K 08的申请， 调查身体健康护理的质量提供给人的严重 精神疾病（SMI）。该应用程序需要一个综合方案， 研究和培训，旨在为长期方案重点提供信息， 护理质量（QOC）评估方法和相关转化工作 改善向人民提供协调/综合医疗保健的情况， 和SMI一起生活最近的重点赠款突出丙型肝炎（HCV） 作为一个重要的启发式示踪条件， 的提供、获取、协调和利用问题 高质量的医疗保健更普遍地存在于重度精神病患者中。 研究部分包括三个项目。第一个建议是， HCV感染成人SMI的自然前瞻性随访。研究 旨在比较两个国家的临床管理实践和护理基准， 不同的服务系统为重度精神障碍的成年人提供服务。第二项研究，建筑 关于精神分裂症研究中现有的护理质量评估（Anthony Lehman，P.I.），扩大医疗开支专题调查的适用范围， 和人权高专办主办的全国调查，以评估医疗服务 精神分裂症患者队列中的药物利用率 在社区精神健康中心接受治疗。该项目还 记录HVC血清学检测的范围，并评估患者 与接受此类测试相关的特征。第三项研究， 在综合退伍军人事务部复制以前的项目 医疗保健系统，将允许在两个服务系统之间进行比较。 教育/培训部分，其结构与 通知研究部分将提供三个一般的高级培训， 领域：1）传染病和临床流行病学; 2）护理质量和 心理健康服务研究设计方法; 3）转化 方法和服务研究的应用，为实践提供信息。的 教育/培训计划的总体目标是提高 建议的研究方法的严谨性，并促进能力， 研究人员将这些研究领域纳入进一步的项目。

DESCRIPTION (Provided by applicant): This is a request for an NIMH RCA-K08 to investigate the quality of somatic health care available to people with serious mental illness (SMI). The application calls for an integrated program of research and training designed to inform a long-term programmatic focus on quality of care (QOC) assessment methodology and related translational efforts to improve the delivery of coordinated/integrated medical care for people living with SMI. The proximal focus of the grant highlights hepatitis C (HCV) as an important heuristic tracer condition for understanding somatic comorbidity and issues of availability, access, coordination and utilization of quality medical care more generally among people living with SMI. The research component consists of three projects. The first proposes a naturalistic prospective follow-up of HCV infected adults with SMI. The study aims to compare clinical management practices and benchmarks of care across two different service systems serving adults with SMI. The second study, building on an existing Quality of Care Assessment in Schizophrenia study (Anthony Lehman, P.I.), extends the application of the Medical Expenditure Panel Survey, and AHCPR-sponsored national survey, to the assessment of medical services utilization among a cohort of adults living with schizophrenia and receiving treatment at an outpatient community mental health center. The project also documents the extent of serological testing for HVC and evaluates patient characteristics that correlated with receipt of such testing. The third study, a replication of the previous project in an integrated Veterans Affairs healthcare system, will allow for comparisons across the two service systems. The educational/training component, constructed to interdigitate with and inform the research component will provide advanced training in three general areas: 1) Infectious disease and clinical epidemiology; 2) Quality of care and mental health services research design methodologies; and 3) Translational methodologies and the application of services research to inform practice. The overall goal of the educational/training program is to increase the methodological rigor of the proposed research and to facilitate the ability of the investigator to integrate these domains of research into further projects.