Hepner Kimberly A, Roth Carol P, Farris Coreen, Sloss Elizabeth M, Martsolf Grant R, Pincus Harold Alan, Watkins Katherine E, Batka Caroline, Mandel Daniel, Hosek Susan D, Farmer Carrie M
Rand Health Q. 2015 Nov 30;5(2):16.
In recent years, the number of U.S. service members treated for psychological health conditions has increased substantially. In particular, at least two psychological health conditions-posttraumatic stress disorder (PTSD) and major depressive disorder (MDD)-have become more common, with prevalence estimates up to 20 percent for PTSD and 37 percent for MDD. Delivering quality care to service members with these conditions is a high-priority goal for the military health system (MHS). Meeting this goal requires understanding the extent to which the care the MHS provides is consistent with evidence-based clinical practice guidelines and its own standards for quality. To better understand these issues, RAND Corporation researchers developed a framework to identify and classify a set of measures for monitoring the quality of care provided by the MHS for PTSD and MDD. The goal of this project was to identify, develop, and describe a set of candidate quality measures to assess care for PTSD and MDD. To accomplish this goal, the authors performed two tasks: (1) developed a conceptual framework for assessing the quality of care for psychological health conditions and (2) identified a candidate set of measures for monitoring, assessing, and improving the quality of care for PTSD and MDD. This article describes their research approach and the candidate measure sets for PTSD and MDD that they identified. The current task did not include implementation planning but provides the foundation for future RAND work to pilot a subset of these measures.
近年来，因心理健康问题接受治疗的美国军人数量大幅增加。特别是，至少两种心理健康状况——创伤后应激障碍（PTSD）和重度抑郁症（MDD）——变得更加普遍，PTSD的患病率估计高达20%，MDD为37%。为患有这些疾病的军人提供高质量护理是军事卫生系统（MHS）的首要目标。要实现这一目标，需要了解MHS提供的护理在多大程度上符合循证临床实践指南及其自身的质量标准。为了更好地理解这些问题，兰德公司的研究人员制定了一个框架，用于识别和分类一套衡量MHS为PTSD和MDD提供的护理质量的指标。该项目的目标是识别、制定和描述一套用于评估PTSD和MDD护理的候选质量指标。为实现这一目标，作者执行了两项任务：（1）制定了一个评估心理健康状况护理质量的概念框架；（2）确定了一组用于监测、评估和改善PTSD和MDD护理质量的候选指标。本文描述了他们的研究方法以及他们确定的PTSD和MDD的候选指标集。当前任务不包括实施规划，但为兰德公司未来对这些指标的一个子集进行试点的工作提供了基础。
