Measuring the Quality of Outpatient Treatment for Schizophrenia

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Abstract
AGENCIES THAT fund public mental health care are currently implementing management strategies that, while designed to improve access and efficiency, could have powerful unanticipated effects on the quality of care.1 Fiscal technologies developed to manage behavioral health benefits of private corporations are being applied to public systems that care for severe, chronic disorders such as schizophrenia. Concerns that severely ill individuals may be at increased risk for poor outcomes under these new financing systems2-4 have led public agencies to increase their oversight functions.5 However, surprisingly little is known about how to monitor quality of care for schizophrenia,6 or what "benchmarks" of quality exist in treatment organizations.7,8 If we are to evaluate the impact of managed care or quality improvement efforts on severely ill populations, then we need quality evaluation methods that can be broadly implemented in public settings.9