Quality of Somatic Care for the Seriously Mentally III

描述(由申请人提供)：这是一份申请NIMH RCA-K08的申请书 调查重症患者可获得的躯体保健质量 精神疾病(SMI)。该应用程序需要一个集成的程序 旨在为长期规划重点提供信息的研究和培训 护理质量(QOC)评估方法和相关的翻译工作 改善为人民提供协调/综合医疗服务 和SMI一起生活。赠款的近端病灶突出了丙型肝炎(丙型肝炎) 作为理解体细胞的重要启发式示踪条件 可获得性、可获取性、协调性和利用率的共病和问题 在患有SMI的人中更普遍地提供高质量的医疗服务。 研究部分由三个项目组成。第一个建议是 丙型肝炎病毒感染的成年SMI患者的自然前瞻性随访。这项研究 旨在比较临床管理实践和护理基准 为患有SMI的成年人提供不同的服务系统。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(安东尼 雷曼兄弟，P.I.)，扩大了医疗支出小组调查的适用范围， 和AHCPR赞助的全国调查，以评估医疗服务 成人精神分裂症患者队列中的利用度 在门诊社区精神卫生中心接受治疗。该项目还 记录HVC的血清学检测范围并评估患者 与接受此类检测相关的特征。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，构建为与和 通知研究部门将在三个方面提供高级培训 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)翻译 服务研究的方法论和应用，为实践提供信息。这个 教育/培训方案的总体目标是增加 拟议研究的方法严谨性，并促进 研究人员将这些研究领域整合到进一步的项目中。

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.