Quality of Care for Bipolar Disorder

项目概述：该导师职业发展奖将允许精神病学家Alisa Busch博士进一步发展她的心理健康服务研究技能，并进行临床相关和政策重要的研究，研究解释双相情感障碍（BPD）常规护理质量的因素。这项职业发展计划的具体目标是：1)加深对统计、卫生经济学和精神卫生系统/组织安排的理解，以及它们在精神卫生服务研究中的应用；2)进一步了解与BPD和共病物质使用障碍相关的临床研究问题；3)扩大对患者（包括种族/民族）、提供者、治疗、资金和组织特征与BPD常规护理质量相关的知识。在这项工作中，Busch博士将由她的赞助人Richard Frank博士、共同赞助人Gary Sachs医学博士和Sharon-Lise T. Normand博士以及无偿顾问Arnold Epstein医学博士、Howard Goldman医学博士、公共卫生博士、公共卫生博士、Shelly Greenfield医学博士、公共卫生博士、Thomas McGuire博士和Roger Weiss医学博士指导。双相情感障碍系统治疗增强计划（STEP-BD）的全国性多地点临床疗效试验的提供者和治疗特征与结果相关。研究2将STEP-BD参与者的特征与私人保险的常规护理BPD人群的特征相匹配；然后描述质量，模拟结果，并检查结果与常规护理BPD人群的组织/财务安排之间的关系。研究3使用STEP-BD数据探索特定地点特征与质量之间的关系。拟议的职业发展计划将为Busch博士提供所需的培训、指导、时间和资源，以发展技能，使她能够领导关于检查常规护理系统质量的独立研究。相关性：关于BPD常规护理质量的现有文献很少，但建议关注质量。从公共卫生政策的角度来看，探索和消除日常护理质量的障碍至关重要。本建议探讨解释BPD日常护理质量的因素。

DESCRIPTION (provided by applicant): Project Summary: This Mentored Career Development Award will allow Dr. Alisa Busch, a psychiatrist, to further develop her mental health services research skills and conduct clinically-relevant and policy significant research examining factors that explain the quality of usual care for bipolar disorder (BPD). The specific aims of this career development proposal are to: 1) develop greater understanding of statistics, health economics and mental health systems/organizational arrangements and their application in mental health services research; 2) acquire further knowledge of clinical research issues pertaining to BPD and comorbid substance use disorders; and 3) expand knowledge of patient (including race/ethnicity), provider, treatment, financing and organizational characteristics associated with BPD usual care quality. In this undertaking, Dr. Busch will be guided by her sponsor Richard Frank, Ph.D., co-sponsors Gary Sachs, M.D. and Sharon-Lise T. Normand, Ph.D., and non-paid consultants Arnold Epstein, M.D., Howard Goldman, M.D., M.P.H., Ph.D., Shelly Greenfield, M.D., M.P.H., Thomas McGuire, Ph.D. and Roger Weiss, M.D. Study 1 examines patient, provider and treatment characteristics associated with outcomes in a national multi-site clinical effectiveness trial for BPD Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Study 2 matches STEP-BD participant characteristics with those of a privately insured usual care BPD population; then describes quality, simulates outcomes, and examines the association between outcomes and organizational/financial arrangements in the usual care BPD population. Study 3 uses STEP-BD data to explore the association between site-specific characteristics and quality. The proposed career development plan will provide Dr. Busch the training, mentoring, time and resources needed to develop skills that will position her to lead independent research on examining quality in usual care systems. Relevance: Existing literature on usual care quality for BPD is scant but suggests quality concerns. From a public health policy perspective, exploring and removing barriers to usual care quality is critical. This proposal examines factors that explain the quality of usual care for BPD.