scholarly journals Gaining knowledge of Ontario’s community mental health and addictions system: linking community-based health services data with administrative health data in Toronto, Ontario, Canada

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Paul Kurdyak ◽  
Abigail Amartey ◽  
Julie Yang ◽  
Daniel Liadsky ◽  
Rachel Solomon ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Service ◽  
Health Services ◽  
Community Health ◽  
Community Health Services ◽  
Health Data ◽  
Local Health ◽  
Community Based ◽  
Administrative Health Data

IntroductionIn most developed countries, a significant amount of mental health and addictions care occurs in community settings. Data reflecting populations served by community-based mental health and addictions providers and the types of services provided are not available, resulting in an incomplete reflection of the entire mental health and addictions system within existing administrative data. Objectives and ApproachThe Community Business Intelligence (CBI) initiative is a data collection project that captures information on adults receiving community-based mental health, addictions, and support services in Toronto Central Local Health Integration Network (LHIN), located in Ontario, Canada. Leveraging administrative health data and data linkage capacity at the Institute for Clinical Evaluative Sciences (ICES), along with engagement of external stakeholders knowledgeable of CBI and the community health sector, we linked the 2015/16 CBI dataset to administrative health data. Demographic characteristics, health-service utilization, primary care attachment, and 30-day emergency department (ED) revisits were calculated for individuals accessing community health services. ResultsThere was an 80.8% linkage rate, of which 36.9% linked deterministically via health card number, while 43.9% linked probabilistically. After study exclusions, 37,688 individuals in the CBI dataset used community health services between April 2015 and March 2016. Compared to Toronto Central LHIN, a greater proportion in the CBI dataset were female, older than 65 years of age, and living in a low income neighbourhood. Furthermore, 95.5%of individuals had at least one outpatient physician visit, 51.3%had at least one ED visit, and 21.7%had at least one hospitalization in the past year. Few individuals in the CBI dataset were without primary care attachment (4.5%); however, a larger proportion had a 30-day ED revisit, particularly those receiving community addictions services (19%). Conclusion/ImplicationsThe availability of community health services data in the CBI dataset and its successful linkage to the administrative health data held at ICES identified health service intersections and outcomes that were previously unknown. This linkage project demonstrates a successful framework for sector-wide performance measurement to address a critical infrastructure gap.

scholarly journals General practitioner fundholding and psychiatric practice

1993 ◽  
Vol 17 (4) ◽  
pp. 193-195 ◽  
Author(s):  
Andrew Sims
Keyword(s):  
Mental Health ◽  
General Practitioner ◽  
National Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Community Health ◽  
Service Management ◽  
Community Health Services ◽  
Personal View

This is a personal view on the implications for mental health services of the Executive Letter of the National Health Service Management Executive (NHSME), published in July 1992 (EL (92) 48): ‘Guidance on the extension of the Hospital and Community Health Services elements of the GP Fundholding Scheme from 1st April, 1993’.

Commissioning of healthcare through competitive and cooperative mechanisms under the HSCA 2012

2020 ◽  
pp. 83-102
Author(s):  
Dorota Osipovic ◽  
Pauline Allen ◽  
Elizabeth Shepherd ◽  
Christina Petsoulas ◽  
Anna Coleman ◽  
...  
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Health Services ◽  
Community Health ◽  
Large Scale ◽  
Community Health Services ◽  
Local Health ◽  
Procurement Process ◽  
Competition And Cooperation ◽  
Marked Decline

Chapter 6 reports a longitudinal study of commissioners’ (and providers’) use of competition and cooperation. This chapter reports research which aimed to investigate how commissioners in local health systems managed the interplay of competition and cooperation in their local health economies, looking at acute, mental health and community health services. The understanding of the regulatory context of the NHS market by both commissioners and providers of care was unclear. There were differences between local areas in terms of the volume and mode of using competition as a commissioning mechanism, with some having more enthusiasm for and experience in running competitive procurements than others. Commissioners noted that the procurement process was very resource intensive. By 2018 there was a marked decline in the appetite to use competition, especially for large scale service reconfigurations. Collaborative planning involving key local providers was a preferred way for CCG commissioners to approach large commissioning tasks.

scholarly journals Commissioning mental health services: role of the consultant psychiatrist

2000 ◽  
Vol 6 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Chris Simpson
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practitioner ◽  
National Health Service ◽  
Health Service ◽  
Health Services ◽  
Consultant Psychiatrist ◽  
Health Authorities ◽  
Care Groups

The current National Health Service (NHS) approach to commissioning health services is in flux. The purchasing of care from providers by general practitioner fundholders (GPFHs) and health authorities has changed with the new White Papers. GPFHs no longer exist and the commissioning role is being handed over from health authorities to primary care groups (PCGs). An understanding of the reasons for change and current arrangements will aid the consultant psychiatrist in influencing this process.

Evaluating models of working at the interface between mental health services and primary care

1997 ◽  
Vol 170 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Linda Gask ◽  
Bonnie Sibbald ◽  
Francis Creed
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Service Providers ◽  
Psychiatric Nurses ◽  
Local Health ◽  
Care Services ◽  
Secondary Health Care

BackgroundThis paper examines the feasibility of evaluating innovative models of working at the interface between primary care and secondary mental health services.MethodMethodological problems relevant to evaluation of innovative models of working at the interface are discussed.ResultsAlthough there is some evidence that neurotic disorders can be more cost-effectively treated in primary care, many general practitioners (GPs), and possibly some patients, prefer referral to community mental health teams and community psychiatric nurses, which are provided by the secondary health care services. Since the latter are provided with the intention of improving serious mental illness their involvement in the care of neurotic illness can lead to tensions between GPs, local health authorities and service providers. There is little evidence to suggest that psychiatrists working in health centres using the ‘shifted out-patient’ model have eased this problem. By contrast the ‘consultation-liaison’ (C-L) model has a number of theoretical advantages; referrals to secondary care should be limited to those most in need of this level of expertise and GP management skills should improve, so leading to better quality of care for patients who are not referred.ConclusionStudies comparing the different models of service delivery are required to address the tensions that have arisen following changes in government policy. Further work is also needed to develop the necessary research tools.

Competency requirements for middle and senior managers in community health services

2013 ◽  
Vol 19 (3) ◽  
pp. 256 ◽  
Author(s):  
Zhanming Liang ◽  
Peter F. Howard ◽  
Lee C. Koh ◽  
Sandra Leggat
Keyword(s):  
Health Service ◽  
Health Services ◽  
Community Health ◽  
Rural Areas ◽  
Online Survey ◽  
Service Management ◽  
Core Competencies ◽  
Community Health Services ◽  
Health Care Environment ◽  
Future Health

The Australian health system has been subjected to rapid changes in the last 20 years to meet increasingly unmet health needs. Improvement of the efficiency and comprehensiveness of community-based services is one of the solutions to reducing the increasing demand for hospital care. Competent managers are one of the key contributors to effective and efficient health service delivery. However, the understanding of what makes a competent manager, especially in the community health services (CHS), is limited. Using an exploratory and mixed-methods approach, including focus group discussions and an online survey, this study identified five key competencies required by senior and mid-level CHS managers in metropolitan, regional and rural areas of Victoria: Interpersonal, communication qualities and relationship management; Operations, administration and resource management; Knowledge of the health care environment; Leading and managing change; and Evidence-informed decision-making. This study confirms that core competencies do exist across different management levels and improves our understanding of managerial competency requirements for middle to senior CHS managers, with implications for current and future health service management workforce development.

Rural and regional community health service boards: perceptions of community health – a Delphi study

2017 ◽  
Vol 23 (6) ◽  
pp. 543 ◽  
Author(s):  
Diana Guzys ◽  
Guinever Threlkeld ◽  
Virginia Dickson-Swift ◽  
Amanda Kenny
Keyword(s):  
Health Service ◽  
Health Services ◽  
Community Health ◽  
Delphi Study ◽  
Healthcare Services ◽  
Community Health Services ◽  
Health Improvement ◽  
Strategic Direction ◽  
Rural Community Health ◽  
Governance Training

Much has been written about the composition of health service boards and the importance of recruiting people with skills appropriate for effective and accountable governance of health services. Governance training aims to educate directors on their governance responsibilities; however, the way in which these responsibilities are discharged is informed by board members’ understanding of health within their communities. The aim of this study was to identify how those engaged in determining the strategic direction of local regional or rural community health services in Victoria, Australia, perceived the health and health improvement needs of their community. The Delphi technique was employed to facilitate communication between participants from difference geographic locations. The findings of the study highlight the different ways that participants view the health of their community. Participants prioritised indicators of community health that do not align with standard measures used by government to plan for, fund or report on health. Devolved governance of healthcare services aims to improve local healthcare responsiveness. Yet, if not accompanied with the redistribution of resources and power, policy claimed to promote localised decision-making is simply tokenistic.

scholarly journals Promotion of Mental Health Rehabilitation in China: Community- Based Mental-Health Services

2020 ◽  
Vol 1 (2) ◽  
pp. 21-27
Author(s):  
Y. Zhu ◽  
X. Li ◽  
M. Zhao
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
National Standards ◽  
Chinese Government ◽  
Public Health Services ◽  
Community Based ◽  
The 1960S

Community-based mental health services are important for the treatment and recovery of patients with mental health disorders. The Chinese government has made the establishment of a highly efficient community-based health service an enduring priority. Since the 1960s, community-based mental health services have been developed in many Chinese cities and provinces. National policies, including mental health regulations and five-year national mental health working plans, have been issued to support the development of quality of mental health services. The accessibility and efficiency of community-based mental health services are now highly promoted to community residents. According to the National Standards for Primary Public Health Services, community-based mental health services are one of the most important components of primary public health services. They are mainly provided via Community Health Service Centres (CHCs), by a combination of general practitioners, public health physicians, nurses and social workers. Patients receive individualized and continuous health services according to their rehabilitation status. These services include regular physical examination, health education, rehabilitation guidance, social function rehabilitation training, vocational training and referral services; family members also receive care and psychological support. Future work will focus on expanding mental health service coverage and usage, increasing awareness of mental health and decreasing stigma, and strengthening service capability to establish an integrated model to enhance the overall efficiency of mental health services.

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