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.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Scientist Development Award - Research & Training (K01)
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Study Section
Services Research Review Committee (SRV)
Program Officer
Hill, Lauren D
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Harvard University
Schools of Medicine
United States
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Busch, Alisa B; He, Yulei; Zelevinsky, Katya et al. (2015) Predicting Participation in Psychiatric Randomized Controlled Trials: Insights From the STEP-BD. Psychiatr Serv 66:817-23
O'Malley, Alistair J; Zelevinsky, Katya; He, Yulei et al. (2015) Do Patients at Sites With High RCT Enrollment Propensity Have Better Outcomes? Med Care 53:989-95
Busch, Alisa B; Yoon, Frank; Barry, Colleen L et al. (2013) The effects of mental health parity on spending and utilization for bipolar, major depression, and adjustment disorders. Am J Psychiatry 170:180-7
Dusetzina, Stacie B; Cook, Benjamin L; Busch, Alisa B et al. (2013) Racial-ethnic differences in incident olanzapine use after an FDA advisory for patients with schizophrenia. Psychiatr Serv 64:83-7
Fung, Vicki; Price, Mary; Busch, Alisa B et al. (2013) Adverse clinical events among medicare beneficiaries using antipsychotic drugs: linking health insurance benefits and clinical needs. Med Care 51:614-21
Barry, Colleen L; Chien, Alyna T; Normand, Sharon-Lise T et al. (2013) Parity and out-of-pocket spending for children with high mental health or substance abuse expenditures. Pediatrics 131:e903-11
Busch, Alisa B; Neelon, Brian; Zelevinsky, Katya et al. (2012) Accurately predicting bipolar disorder mood outcomes: implications for the use of electronic databases. Med Care 50:311-9
Goldman, Howard H; Barry, Colleen L; Normand, Sharon-Lise T et al. (2012) Economic grand rounds: the price is right? Changes in the quantity of services used and prices paid in response to parity. Psychiatr Serv 63:107-9
Fullerton, Catherine A; Busch, Alisa B; Normand, Sharon-Lise T et al. (2011) Ten-year trends in quality of care and spending for depression: 1996 through 2005. Arch Gen Psychiatry 68:1218-26
Yoon, Frank B; Huskamp, Haiden A; Busch, Alisa B et al. (2011) Using Multiple Control Groups and Matching to Address Unobserved Biases in Comparative Effectiveness Research: An Observational Study of the Effectiveness of Mental Health Parity. Stat Biosci 3:63-78

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