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The effectiveness of mental health service delivery in the general hospital

Objective

The primary goals of the EC concerted action are the formulation of guidelines for Mental Health (C-L) Service Delivery in the general hospital setting through: 1) the description of the nature and organization of mental health C-L services in general hospitals, and 2) the assessment of the impact of the availability of these mental health services on the quantity and quality of its service delivery.

The general objectives of the study can be broken down into specific objectives addressed by a number of studies of increasing complexity, focussing on standardization of instrumentation for epidemiology, service delivery, comorbidity and cost-effectiveness analyses. The most important of these are:

- How can general hospital inpatients referred to C-L services be reliably described regarding social, medical and psychological history and assessment (development of instruments)?
- What kinds of patients are being referred to C-L, and where do they come from?
- Is it possible to identify special high risk groups which should be screened for routinely?
- How is the clinical course (outcome) of patients referred to C-L?
- What is the relationship between C-L service delivery profiles and patient clinical outcome?
- What is the relationship between C-L service delivery profiles and patient clinical outcome?
- How do C-L service delivery profiles differ with regard to specified diagnostic groups (eg eating disorders, organic brain syndromes)?
- Are there national differences concerning types of patients referred, diagnostic and therapeutic interventions?
- Are there distinct types of C-L services regarding structural and functional variables, and are these related to differences between countries?
- What are the costs of (adequate) C-L services relative to total treatment costs?
- What the indications that adquate C-L services help avoid inappropriate medical treatment, shorten length of stay and thereby reduce costs?
- What is the relation between the number of patients referred, their length of hospital stay and time spent on consultations (per patient); is this related to consultation rate and availability of C-L services?
- What is the impact of both hospital and service characteristics (including manpower) on the types of patients referred, and on the extent and quality of service delivery of the consultants?
- How do educational and personal (including national) background of consultants influence the type of service delivered relative to patient variables?

Coordinator

Free University Hospital
Address

1007 MB Amsterdam
Netherlands