Evidence map›Paper›PMID 25496562›Full record

ArticleBMC health services research2014

Factors explaining priority setting at community mental health centres: a quantitative analysis of referral assessments.

Sverre Grepperud, Per Arne Holman, Knut Reidar Wangen

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Article in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Sverre GrepperudDepartment of Health Management and Health Economics, University of Oslo, PO 1089, N-0317, Oslo, Norway. sverre.grepperud@medisin.uio.no.
Per Arne HolmanLovisenberg Diakonale Hospital, N-0440, Oslo, Norway. paho@lds.no.
Knut Reidar WangenDepartment of Health Management and Health Economics, University of Oslo, PO 1089, N-0317, Oslo, Norway. k.r.wangen@medisin.uio.no.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinicians at Norwegian community mental health centres assess referrals from general practitioners and classify them into three priority groups (high priority, low priority, and refusal) according to need where need is defined by three prioritization criteria (severity, effect, and cost-effectiveness). In this study, we seek to operationalize the three criteria and analyze to what extent they have an effect on clinical-level priority setting after controlling for clinician characteristics and organisational factors.

methodsTwenty anonymous referrals were rated by 42 admission team members employed at 14 community mental health centres in the South-East Health Region of Norway. Intra-class correlation coefficients were calculated and logistic regressions were performed.

resultsVariation in clinicians' assessments of the three criteria was highest for effect and cost-effectiveness. An ordered logistic regression model showed that all three criteria for prioritization, three clinician characteristics (education, being a manager or not, and "guideline awareness"), and the centres themselves (fixed effects), explained priority decisions. The relative importance of the explanatory factors, however, depended on the priority decision studied. For the classification of all admitted patients into high- and low-priority groups, all clinician characteristics became insignificant. For the classification of patients, into those admitted and non-admitted, one criterion (effect) and "being a manager or not" became insignificant, while profession ("being a psychiatrist") became significant.

conclusionsOur findings suggest that variation in priority decisions can be reduced by: (i) reducing the disagreement in clinicians' assessments of cost-effectiveness and effect, and (ii) restricting priority decisions to clinicians with a similar background (education, being a manager or not, and "guideline awareness").

Indexed as

Community Mental Health CentersHealth PrioritiesReferral and ConsultationAdultAwarenessCost-Benefit AnalysisFemaleGeneral PracticeHealth Services AccessibilityHospitalizationHumansLogistic ModelsMaleMiddle AgedNorway

Identifiers

PMID25496562
PMCPMC4272526

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.