This is a proposal for a Research Scientist Award for Dr. Kenneth Wells. The research plan is based on Donabedian's model of the components of quality of care (structure, process, outcomes), as applied to individuals with affective disorders or other serious psychiatric illness. The research focuses on improving definitions and measures of quality and outcomes of care and identifying sources of variation in quality and outcomes of care, but particularly effects of alternative strategies to finance mental health care under prepaid and managed care arrangements. The research will be pursued through a variety of research activities including studying and refining existing measures, analyzing existing data bases from previously funded grants, and developing new studies of variations in quality and outcomes of care. This work involves development of a joint research program at RAND and UCLA, and incorporation of new research perspectives (for example, ethnographic methods to further develop the concept of functional status outcomes). An additional research goal is to identify strategies to improve quality of care for patients with affective and other serious psychiatric disorders, focusing on interventions, such as continuous quality improvement and approaches based on social influences theory, that are designed to alter the structure and clinical operations of practice environments. This work will be accomplished through collaboration with a newly funded Center for Changing Provider Behavior at the Sepulveda Veterans Administration Hospital, and applying these approaches to psychiatric conditions. Science education, in particular mentoring of junior clinical investigators, in mental health services research is also a major aim of the proposed RSA.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Scientist Award (K05)
Project #
5K05MH001170-04
Application #
2415759
Study Section
Special Emphasis Panel (SRCM (03))
Project Start
1994-05-01
Project End
1999-04-30
Budget Start
1997-05-01
Budget End
1998-04-30
Support Year
4
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Rost, Kathryn; Dickinson, L Miriam; Fortney, John et al. (2005) Clinical improvement associated with conformance to HEDIS-based depression care. Ment Health Serv Res 7:103-12
Rost, Kathryn; Fortney, John; Coyne, James (2005) The relationship of depression treatment quality indicators to employee absenteeism. Ment Health Serv Res 7:161-9
Koike, Alan K; Unutzer, Jurgen; Wells, Kenneth B (2002) Improving the care for depression in patients with comorbid medical illness. Am J Psychiatry 159:1738-45
Schoenbaum, Michael; Unutzer, Jurgen; McCaffrey, Daniel et al. (2002) The effects of primary care depression treatment on patients' clinical status and employment. Health Serv Res 37:1145-58
Kataoka, Sheryl H; Zhang, Lily; Wells, Kenneth B (2002) Unmet need for mental health care among U.S. children: variation by ethnicity and insurance status. Am J Psychiatry 159:1548-55
Wells, Kenneth B; Sherbourne, Cathy Donald; Sturm, Roland et al. (2002) Alcohol, drug abuse, and mental health care for uninsured and insured adults. Health Serv Res 37:1055-66
Schoenbaum, M; Unutzer, J; Sherbourne, C et al. (2001) Cost-effectiveness of practice-initiated quality improvement for depression: results of a randomized controlled trial. JAMA 286:1325-30
Dwight-Johnson, M; Unutzer, J; Sherbourne, C et al. (2001) Can quality improvement programs for depression in primary care address patient preferences for treatment? Med Care 39:934-44
Wells, K; Klap, R; Koike, A et al. (2001) Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. Am J Psychiatry 158:2027-32
Wells, K B; Sherbourne, C; Schoenbaum, M et al. (2000) Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial. JAMA 283:212-20

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