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019 a| 1117882439;

042 a| pcc;

043 a| n-us---;

049 a| ERE#;

074 a| 0985-A-12 (online);

086 0 a| VA 1.107/3:Q 2;

100 1 a| Gierisch, Jennifer M.,e| author.=| ^A1330050;

245 10 a| Health disparities in quality indicators of healthcare among adults with mental illness /c| Jennifer M. Gierisch [and twelve others].;

264 1 a| Washington, DC :b| Department of Veterans Affairs, Veterans Health Administration, Quality Enhancement Research Initiative, Health Services Research and Development Service,c| October 2014.;

300 a| 1 online resource (iv, 101 pages) :b| illustrations (some color);

336 a| textb| txt2| rdacontent;

337 a| computerb| c2| rdamedia;

338 a| online resourceb| cr2| rdacarrier;

500 a| "Evidence-based synthesis program.";

500 a| "October 2014.";

500 a| GPO Cataloging Record Distribution Program (CRDP).;

504 a| Includes bibliographical references.;

520 3 a| The burden of mental illness among Veterans is substantial, and medical illnesses such as diabetes and cardiovascular disease affect a disproportionate number of people with mental illness. For example, more than 90% of people with serious mental illness (SMI) (eg, schizophrenia, bipolar disorder) have co-occurring chronic medical conditions such as hypertension, cardiovascular disease, hyperlipidemia, or diabetes. These chronic medical conditions, when co-occurring with mental illness, are more detrimental to overall health than in the general population, and people with comorbid mental illness and chronic medical conditions have higher hospitalization rates and healthcare costs than those with comparable chronic medical conditions alone.^Disparities in health between people with and without mental illness are likely due to a combination of factors such as the effect of mental illness on an individual's capacity to maintain health, the adverse effects of medications used to treat mental illness, individual-level modifiable risk factors (eg, smoking, physical inactivity), and lower quality of healthcare. Healthcare systems are complex organizations, and assessing quality within these organizations is challenging. One approach to evaluating quality of care within healthcare systems is the use of tracer conditions as quality indicators. This approach focuses on targeted prevalent conditions for which strong evidence and agreement concerning appropriate processes of care (eg, annual foot exams for patients with diabetes) and goals of therapy (eg, blood pressure <140/90) exist; making it possible to uncover deficits in complex healthcare systems.^Chronic medical illnesses such as diabetes, heart disease, and hypertension are highly prevalent among VA patients: an estimated 72% have one or more chronic medical illnesses (compared to 40% to 50% of other U.S. adults), and over half have at least 2 such conditions. Thus, diabetes, hypertension, and ischemic heart disease may serve as ideal tracer conditions to assess quality in the Veterans Affairs (VA) healthcare system as a whole. In similar fashion, receipt of selected recommended preventive screenings and services provides an opportunity to examine system-level quality of care among certain subpopulations. In order to guide future research and policy decisions for the VA, the VA Office of Heath Equity partnered with the Evidence-based Synthesis Program (ESP) to conduct a systematic review of health disparities in quality indicators of healthcare among adults with mental illness.^We evaluated comparative studies that assessed a broad range of preventive care and chronic disease management quality indicators to assess if, and to what extent, disparities in healthcare exist for individuals with mental illness.;

536 a| VA ESPf| 09-101;

588 a| Description based on online resource; title from PDF cover (VA, viewed March 19, 2021).;

650 0 a| Mentally illx| Medical carez| United States.=| ^A8786;

650 0 a| Outcome assessment (Medical care)z| United States.=| ^A1006293;

650 7 a| Mentally illx| Medical care.2| fast0| (OCoLC)fst01016751;

650 7 a| Outcome assessment (Medical care)2| fast0| (OCoLC)fst01049109;

651 7 a| United States.2| fast0| (OCoLC)fst01204155?| UNAUTHORIZED;

710 2 a| Quality Enhancement Research Initiative (U.S.)=| ^A631177;

710 2 a| Durham VA Medical Center.b| Evidence-based Synthesis Program Center.=| ^A1330052;

710 2 a| Evidence-based Synthesis Program (U.S.)?| UNAUTHORIZED;

856 40 u| https://purl.fdlp.gov/GPO/gpo1540627| 0;

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949 a| Click on web addressw| asish| joyner94;

596 a| 1;

998 a| 5631742;

999 a| CLICK ON WEB ADDRESSw| ASISc| 1i| 5631742-1001l| JNETm| JOYNERr| Ys| Yt| JNE1DOu| 5/15/2021x| EDOCUMENTz| JERESOURCE;

Health disparities in quality indicators of healthcare among adults with mental illness / Jennifer M. Gierisch [and twelve others].

Author/creator	Gierisch, Jennifer M. author.
Format	Electronic
Publication	Washington, DC : Department of Veterans Affairs, Veterans Health Administration, Quality Enhancement Research Initiative, Health Services Research and Development Service, October 2014.
Description	1 online resource (iv, 101 pages) : illustrations (some color)
Supplemental Content	https://purl.fdlp.gov/GPO/gpo154062
Subjects	Mentally ill--Medical care. --United States. Outcome assessment (Medical care)--United States.

Other author/creator	Quality Enhancement Research Initiative (U.S.)
Other author/creator	United States. Department of Veterans Affairs. Health Services Research and Development Service, issuing body.
Other author/creator	Durham VA Medical Center. Evidence-based Synthesis Program Center.
Other author/creator	Evidence-based Synthesis Program (U.S.)
Summary	The burden of mental illness among Veterans is substantial, and medical illnesses such as diabetes and cardiovascular disease affect a disproportionate number of people with mental illness. For example, more than 90% of people with serious mental illness (SMI) (eg, schizophrenia, bipolar disorder) have co-occurring chronic medical conditions such as hypertension, cardiovascular disease, hyperlipidemia, or diabetes. These chronic medical conditions, when co-occurring with mental illness, are more detrimental to overall health than in the general population, and people with comorbid mental illness and chronic medical conditions have higher hospitalization rates and healthcare costs than those with comparable chronic medical conditions alone.^Disparities in health between people with and without mental illness are likely due to a combination of factors such as the effect of mental illness on an individual's capacity to maintain health, the adverse effects of medications used to treat mental illness, individual-level modifiable risk factors (eg, smoking, physical inactivity), and lower quality of healthcare. Healthcare systems are complex organizations, and assessing quality within these organizations is challenging. One approach to evaluating quality of care within healthcare systems is the use of tracer conditions as quality indicators. This approach focuses on targeted prevalent conditions for which strong evidence and agreement concerning appropriate processes of care (eg, annual foot exams for patients with diabetes) and goals of therapy (eg, blood pressure <140/90) exist; making it possible to uncover deficits in complex healthcare systems.^Chronic medical illnesses such as diabetes, heart disease, and hypertension are highly prevalent among VA patients: an estimated 72% have one or more chronic medical illnesses (compared to 40% to 50% of other U.S. adults), and over half have at least 2 such conditions. Thus, diabetes, hypertension, and ischemic heart disease may serve as ideal tracer conditions to assess quality in the Veterans Affairs (VA) healthcare system as a whole. In similar fashion, receipt of selected recommended preventive screenings and services provides an opportunity to examine system-level quality of care among certain subpopulations. In order to guide future research and policy decisions for the VA, the VA Office of Heath Equity partnered with the Evidence-based Synthesis Program (ESP) to conduct a systematic review of health disparities in quality indicators of healthcare among adults with mental illness.^We evaluated comparative studies that assessed a broad range of preventive care and chronic disease management quality indicators to assess if, and to what extent, disparities in healthcare exist for individuals with mental illness.
General note	"Evidence-based synthesis program."
General note	"October 2014."
General note	GPO Cataloging Record Distribution Program (CRDP).
Bibliography note	Includes bibliographical references.
Funding information	VA ESP 09-101
Source of description	Description based on online resource; title from PDF cover (VA, viewed March 19, 2021).
GPO item number	0985-A-12 (online)
Govt. docs number	VA 1.107/3:Q 2

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Health disparities in quality indicators of healthcare among adults with mental illness / Jennifer M. Gierisch [and twelve others].

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