The critical factor: The role of quality in the performance of supported accommodation services for complex mental illness in England
Rehabilitation services have a key role in ensuring integrated and comprehensive mental health (MH) care in the community for people suffering from long-term and severe mental disorders. MH-supported accommodation services aim to promote service users' autonomy and independence. Given the compl...
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| Veröffentlicht in: | PloS one 2022-03, Vol.17 (3), p.e0265319-e0265319 |
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| creator | Almeda, Nerea García-Alonso, Carlos Ramón Killaspy, Helen Gutiérrez-Colosía, Mencía R Salvador-Carulla, Luis |
| description | Rehabilitation services have a key role in ensuring integrated and comprehensive mental health (MH) care in the community for people suffering from long-term and severe mental disorders. MH-supported accommodation services aim to promote service users' autonomy and independence. Given the complexity associated with MH-supported accommodation services in England, a comparative evaluation of critical performance indicators, including service provision and quality of care, seems to be necessary in designing evidence-informed policies. This study aims to explore the influence of service quality indicators on the performance of MH-supported accommodation services in England. The analysed sample includes supported accommodation services from 14 nationally representative local authorities in England from the QuEST study grouped by three main types of care: residential care homes (divided into two subgroups: move-on and non-move-on oriented), supported housing and floating outreach. EDeS-MH (efficient decision support-mental health) was used to assess the performance indicators for the selected services by combining a Monte Carlo simulation engine, data envelopment analysis and a fuzzy inference engine for integrating expert knowledge. Depending on the type of care, six/seven quality domains were sequentially included after a baseline scenario (only technical) was analysed. Relative technical efficiency scores for the baseline scenarios revealed high performance in all the selected supported accommodation services, but the statistical variability was high. Quality domains significantly improved performance in every type of care. The inclusion of quality indicators has a positive impact on the global performance of each type of care. Remaining at the corresponding services more than expected for two years has a negative impact on performance. These findings can be considered from a planning perspective to facilitate the design of pathways of care with more realistic expectations about gaining autonomy in two years. |
| doi_str_mv | 10.1371/journal.pone.0265319 |
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MH-supported accommodation services aim to promote service users' autonomy and independence. Given the complexity associated with MH-supported accommodation services in England, a comparative evaluation of critical performance indicators, including service provision and quality of care, seems to be necessary in designing evidence-informed policies. This study aims to explore the influence of service quality indicators on the performance of MH-supported accommodation services in England. The analysed sample includes supported accommodation services from 14 nationally representative local authorities in England from the QuEST study grouped by three main types of care: residential care homes (divided into two subgroups: move-on and non-move-on oriented), supported housing and floating outreach. EDeS-MH (efficient decision support-mental health) was used to assess the performance indicators for the selected services by combining a Monte Carlo simulation engine, data envelopment analysis and a fuzzy inference engine for integrating expert knowledge. Depending on the type of care, six/seven quality domains were sequentially included after a baseline scenario (only technical) was analysed. Relative technical efficiency scores for the baseline scenarios revealed high performance in all the selected supported accommodation services, but the statistical variability was high. Quality domains significantly improved performance in every type of care. The inclusion of quality indicators has a positive impact on the global performance of each type of care. Remaining at the corresponding services more than expected for two years has a negative impact on performance. 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R</au><au>Salvador-Carulla, Luis</au><au>Pamucar, Dragan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The critical factor: The role of quality in the performance of supported accommodation services for complex mental illness in England</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2022-03-17</date><risdate>2022</risdate><volume>17</volume><issue>3</issue><spage>e0265319</spage><epage>e0265319</epage><pages>e0265319-e0265319</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Rehabilitation services have a key role in ensuring integrated and comprehensive mental health (MH) care in the community for people suffering from long-term and severe mental disorders. MH-supported accommodation services aim to promote service users' autonomy and independence. Given the complexity associated with MH-supported accommodation services in England, a comparative evaluation of critical performance indicators, including service provision and quality of care, seems to be necessary in designing evidence-informed policies. This study aims to explore the influence of service quality indicators on the performance of MH-supported accommodation services in England. The analysed sample includes supported accommodation services from 14 nationally representative local authorities in England from the QuEST study grouped by three main types of care: residential care homes (divided into two subgroups: move-on and non-move-on oriented), supported housing and floating outreach. EDeS-MH (efficient decision support-mental health) was used to assess the performance indicators for the selected services by combining a Monte Carlo simulation engine, data envelopment analysis and a fuzzy inference engine for integrating expert knowledge. Depending on the type of care, six/seven quality domains were sequentially included after a baseline scenario (only technical) was analysed. Relative technical efficiency scores for the baseline scenarios revealed high performance in all the selected supported accommodation services, but the statistical variability was high. Quality domains significantly improved performance in every type of care. The inclusion of quality indicators has a positive impact on the global performance of each type of care. Remaining at the corresponding services more than expected for two years has a negative impact on performance. These findings can be considered from a planning perspective to facilitate the design of pathways of care with more realistic expectations about gaining autonomy in two years.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>35298512</pmid><doi>10.1371/journal.pone.0265319</doi><tpages>e0265319</tpages><orcidid>https://orcid.org/0000-0002-2631-0205</orcidid><orcidid>https://orcid.org/0000-0002-6477-5142</orcidid><orcidid>https://orcid.org/0000-0002-5742-9866</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Accommodation Autonomy Biology and Life Sciences Complexity Data envelopment analysis Decision making Domains Earth Sciences Ecology and Environmental Sciences England Evaluation Housing Humans Indicators Managers Medical care Medicine and Health Sciences Mental disorders Mental Disorders - psychology Mental Health Mental health care Mental Health Services Monte Carlo simulation Outreach services People and places Performance evaluation Physical sciences Psychiatric services Quality management Quality of care Rehabilitation Research and analysis methods Social Sciences Subgroups Supervision Variables |
| title | The critical factor: The role of quality in the performance of supported accommodation services for complex mental illness in England |
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