Healthcare system performance in continuity of care for patients with severe mental illness: A comparison of five European countries

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Pablo Nicaise - , Université catholique de Louvain (Autor:in)
  • Domenico Giacco - , Queen Mary University of London (Autor:in)
  • Bettina Soltmann - , Klinik und Poliklinik für Psychiatrie und Psychotherapie (Autor:in)
  • Andrea Pfennig - , Klinik und Poliklinik für Psychiatrie und Psychotherapie (Autor:in)
  • Elisabetta Miglietta - , University of Verona (Autor:in)
  • Antonio Lasalvia - , Ospedale Policlinico (Autor:in)
  • Marta Welbel - , Institute of Psychiatry and Neurology, Warszawa (Autor:in)
  • Jacek Wciórka - , Institute of Psychiatry and Neurology, Warszawa (Autor:in)
  • Victoria Jane Bird - , Queen Mary University of London (Autor:in)
  • Stefan Priebe - , Queen Mary University of London (Autor:in)
  • Vincent Lorant - , Université catholique de Louvain (Autor:in)

Abstract

Most healthcare systems struggle to provide continuity of care for people with chronic conditions, such as patients with severe mental illness. In this study, we reviewed how system features in two national health systems (NHS) – England and Veneto (Italy) – and three regulated-market systems (RMS) – Germany, Belgium, and Poland –, were likely to affect continuing care delivery and we empirically assessed system performance. 6418 patients recruited from psychiatric hospitals were followed up one year after admission. We collected data on their use of services and contact with professionals and assessed care continuity using indicators on the gap between hospital discharge and outpatient care, access to services, number of contacts with care professionals, satisfaction with care continuity, and helping alliance. Multivariate regressions were used to control for patients’ characteristics. Important differences were found between healthcare systems. NHS countries had more effective longitudinal and cross-sectional care continuity than RMS countries, though Germany had similar results to England. Relational continuity seemed less affected by organisational mechanisms. This study provides straightforward empirical indicators for assessing healthcare system performance in care continuity. Despite systems’ complexity, findings suggest that stronger regulation of care provision and financing at a local level should be considered for effective care continuity.

Details

OriginalspracheEnglisch
Seiten (von - bis)25-36
Seitenumfang12
FachzeitschriftHealth policy
Jahrgang124
Ausgabenummer1
PublikationsstatusVeröffentlicht - Jan. 2020
Peer-Review-StatusJa

Externe IDs

PubMed 31831211
ORCID /0000-0002-3415-5583/work/150329742

Schlagworte

Ziele für nachhaltige Entwicklung

ASJC Scopus Sachgebiete

Schlagwörter

  • Continuity of care, Health care reform, Health planning, Severe mental disorders, Systems analysis