Authors: James J Guinan, Peter Scoufis, Deboral Saltman
Event: 2000 TheMHS Conference
Subject: book of proceedings, continuity of care, mental health, opiate dependence, community health services, continuity measurement.
Type of resource: Conference Presentations and Papers
Abstract: This report is concerned with the development of a clinical instrument to assess client needs in relation to continuity of care. This index was developed with a focus on the clients’ experience of continuity of care. Items for inclusion in the index were obtained from routine assessment and treatment sessions with clients as well as from focus groups in both inpatient and community mental health settings.
A 22-item Consumer Continuity of Care Index was developed and evaluated in regard to its validity and clinical utility in 122 community mental health clients, 50 patients of an acute-care psychiatric unit and 90 clients of a community methadone maintenance program. Four factors were identified, Advocacy-Mutuality, Support Network, Treatment Problems and Doctor Backup. The Index was found to have acceptable internal consistency, construct validity and test-retest reliability.
Different factors were found to have predictive utility in regard to the clinical indicators of continuity of care in both mental health and methadone clients. Specific information about continuity of care needs was obtained by examining the individual items on this index. For example, involvement of the client’s regular doctor in treatment was associated with less need for intervention of the mobile treatment team and fewer hospital admissions. Methadone clients who reported “I believe I get the treatment I need” were more likely to be on the most common therapeutic dose, more likely to be employed and less likely to have dropped off the program during the study period.