1,721,055 research outputs found
La misurazione delle aspettative e della soddisfazione dei pazienti e dei loro familiari nei confronti dei servizi psichiatrici territoriali: la validazione della VECS e della VSSS. II. Sensibilita' e validita' di contenuto
No full textVengono illustrate le proprietà psicometriche della Verona Expectations for Care Scale e della Verona Service Satisfaction Scale, con particolare riferimento alla sensibilità e alla validità di contenuto in base a dati sperimentali ottenuti in un campione rappresentaivo di pazienti in carico al Servizio Psichiatrico Territoriale di Verona Su
La misurazione delle aspettative e della soddisfazione dei pazienti e dei loro familiari nei confronti dei servizi psichiatrici territoriali: la validazione della VECS e della VSSS. I. Accettabilita' e riproducibilita'
No full textVengono illustrate le proprietà psicometriche della Verona Expectations for Care Scale e della Verona Service Satisfaction Scale, con particolare riferimento all'accettabilità e alla riproducibiltà in base a dati sperimentali ottenuti in un campione rappresentaivo di pazienti in carico al Servizio Psichiatrico Territoriale di Verona Su
Collecting psychiatric resources utilisation data to calculate costs of care: a comparison between a service receipt interview and a case register
No full textBackground: Economic assessment of inter-ventions and policies is becoming increasingly common,in large measure because of the growing emphasis oncost containment within health care. Comprehensiveand reliable outcome and cost data are required to ad-vise policy makers and clinicians as to the best use oftheir limited resources. The process of costing can bebroken down into three connected tasks: the collectionof service receipt or utilisation data relative to individualclients or patients over a de®ned period; the costing ofeach of the services used; and the combination of thesetwo sets of information in order to calculate individualcosts. The aim of this study was to compare two meth-odologies of collecting data on individual service use ± acustomised interview schedule, ICAP, and the psychi-atric case register (PCR) ± and to calculate costs, testingthe extent of agreement between them. Method: Theagreement between the ICAP and the PCR costs mea-surement was evaluated using the concordance correla-tion coe cient qc. From all patients (n = 543) who hadatleast one contact with a psychiatrist or a psychologistduring the period October±December 1996, 339 patientswere interviewed using the ICAP. The overall number ofpatients in contact with the South-Verona CPS in thesame period was 630. Results: The agreement betweenthe two sources was very di€erent for each diagnosticgroup and each professional category. However, theoverall agreement on total costs was satisfactory(qc < 0.95). This result is probably due to the e€ect ofthe good agreement observed on more costly services:inpatient care and sheltered accommodation. Conclu-sion: The results suggested practical implications for theuse of the service receipt interview: interviewers shouldbe trained in order to avoid misinterpretation of thede®nitions given in the form; the sources of informationshould be clearly de®ned to tease out all the items ofservices provided for the users; the professionals (i.e.psychiatrists) could in ̄uence the reliability of data col-lection by underestimating services provided by di€erentprofessionals (nurses, social workers, etc.). The ®ndingscon®rm that it is possible to use this approach when theaim is to estimate the whole cost of the services; how-ever, the importance of adopting adequate proceduresfor analysing the complexity of cost components shouldbe pointed out. Only a trained interviewer whothoroughly knows each component of the health andsocial services provided could guarantee an accuratedata collection
Exploring the relationships between patients' characteristics and costs of community-based mental health care
No full textThe Positive Ion Injector for ALPI
No full textIn the framework of the ALPI upgrading, a new positive ion injector is foreseen in order to be able to accelerate ions with masses of the order of 200 and with high charge states from the velocity of β = 0.009 up to β = 0.055. The structures chosen for that velocity range are superconducting radio frequency quadrupoles operating at a frequency of 80 MHz, which is the operating frequency of the ALPI low β cavities. The paper describes the current status of the project including beam dynamics, cavity design, beam transfer lines and vacuum, control and cryogenic systems
Determinants of subjective quality of life in patients attending community-based mental health services. The South-Verona Outcome Project 5
No full textObjective: Investigate the relationship of various domains of quality of life (QoL) with socio-demographics, clinical and social characteristics, service use and satisfaction in a representative sample of patients in contact with the South-Verona community mental health service. Method: Measures included: Lancashire Quality of Life Profile (LQOLP), demographics, diagnosis and service utilization data from the Case Register, Brief Psychiatric Rating Scale (BPRS), Disability Assessment Schedule (DAS), Global Assessment of Functioning (GAF) and Verona Service Satisfaction Scale (VSSS). Analyses were conducted using a block-stratified multiple regression model. Results: Demographics, diagnosis, psychopathology, disability, functioning and service use together explained different amounts of variance in each LQOLP domain, but always less than 14%. VSSS explained more variance than any other indicator in health (13.1%), social relations (12.1%), leisure/participation (9.1%), and general wellbeing (9.0%). Conclusion: Different domains of QoL are predicted by different indicators. In some important domains, self-perceived satisfactory and effective care might have an impact on the QoL of patients
Community-based mental health care: to what extent are services costs associated with clinical, social and service history variables?
No full textBackground. The growing movement in many European countries towards capitation-based systems for financing mental health care has generated increasing interest in developing appropriate models capitation formulae. The aims of the study were: to detect and compare any differences in service costs between patients with different diagnoses; and to analyse the associations between patient characteristics and service costs.
Methods. All patients in contact with the South-Verona Community Mental Health Service during the last quarter of 1996 were included in the study. Clinical and service-related variables were collected at first index contact; 3 months later, patients were interviewed using the Client Services Recipient Interview. For those who completed both the clinical assessments and the services receipt schedule (N= 339), 1-year psychiatric and non-psychiatric direct care costs were calculated. Weighted backward regression analyses were performed.
Results. The most significant variables associated with psychiatric costs were: admission to hospital in the previous year; intensity and duration of previous contacts with South-Verona CMHS; being unemployed; having a diagnosis of affective disorder; and, Global Assessment of Functioning score. The final model explained 66% of the variation in costs of psychiatric care and 13% of variation in non-psychiatric medical costs.
Conclusions. The model presented in this study explains a higher degree of cost variance than previously published studies. In community-based services more resources are targeted towards the most disabled patients. Previous psychiatric history (number of admissions in the previous year and intensity of psychiatric contacts lifetime) is strongly associated with psychiatric costs
Mortality among patients with psychiatric illness. A ten-year case register study in an area with a community-based system of care
No full textBackground. Most studies which showed an excess mortality in psychiatric patients have been conducted on hospitalised samples. Method. This was a case register study. All South Verona patients with an ICD diagnosis who had psychiatric contacts with specialist services in 1982-1991 were included. Mortality was studied in relation to sex, age, diagnosis, pattern of care and interval from registration. Standardised Mortality Rates (SMRs) and Poisson regression analysis were calculated. Results. The overall SMR was 1.63 (95% Cl = 1.5-1.8), which is the lowest value reported so far. Mortality was higher among men (SMR = 2.24; 95% Cl = 1.9-2.6), among patients who were admitted to hospital (SMR = 2.23; 95% Cl = 1.9-2.6), among younger age groups (SMR = 8.82; 95% Cl = 4.9-14.6) and in the first year after registration (SMR = 2.32; 95% Cl = 1.3-2.9). Higher mortality was found in patients with a diagnosis of alcohol and drug dependence (SMR = 3.87; 95% Cl = 3.0-4.9). The SMR for suicide was 17.41. Using a Poisson regression model, diagnosis, pattern of care and interval from registration were all found to be significantly associated with mortality. When all these variables were entered together in the model, each maintained its predictive role. Conclusions. The overall mortality of psychiatric patients treated in a community-based system of care was higher than expected, but lower than the mortality reported in other psychiatric settings. The highest mortality risk was found in the first year after registration
Definition and prevalence of severe and persistent mental illness
No full textBackground: There is little consistency in how severe mental illness (SMI) is defined in practice, and no operational definitions. Aims: To test two operationalised definitions, based on the National Institute of Mental Health (1987) definition: the first uses three criteria (diagnosis of psychosis; duration of service contact ≥ 2 years; GAF score ≤ 50), the second only the last two. Method: Annual prevalence rates of SMI in two European catchment areas for each criterion and the criteria combined were calculated. Results: The first definition produced rates of 2,55 and 1.34/1000 in London and Verona, respectively; the second permitted an additional 0.98/1000 non-psychotic disorders to be included in Verona. Conclusions: The three-dimensional definition selects a small group of patients with SMI who have psychotic disorders. The two-dimensional approach allows estimates of SMI prevalence rates which include all forms of mental disorder. Declaration of interest. Funding provided by the University of Verona and the Bethlem and Maudsley NHS Trust
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