News Release
Areas of Excellence and Need for Improvement Found in Quality of Mental Health Care Provided by the Military
Feb 18, 2016
Understanding the current quality of care for posttraumatic stress disorder (PTSD) and depression delivered to service members is an important step toward improving care across the Military Health System (MHS). This report describes the characteristics of active-component service members who received care for PTSD or depression through the MHS and assesses the quality of care received using quality measures derived from administrative data.
Phase I Report
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The U.S. Department of Defense (DoD) strives to maintain a physically and psychologically healthy, mission-ready force, and the care provided by the Military Health System (MHS) is critical to meeting this goal. Given the rates of posttraumatic stress disorder (PTSD) and depression among U.S. service members, attention has been directed to ensuring the quality and availability of programs and services targeting these and other psychological health (PH) conditions. Understanding the current quality of care for PTSD and depression is an important step toward improving care across the MHS. To help determine whether service members with PTSD or depression are receiving evidence-based care and whether there are disparities in care quality by branch of service, geographic region, and service member characteristics (e.g., gender, age, pay grade, race/ethnicity, deployment history), DoD's Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) asked the RAND Corporation to conduct a review of the administrative data of service members diagnosed with PTSD or depression and to recommend areas on which the MHS could focus its efforts to continuously improve the quality of care provided to all service members. This report characterizes care for service members seen by MHS for diagnoses of PTSD and/or depression and finds that while the MHS performs well in ensuring outpatient follow-up following psychiatric hospitalization, providing sufficient psychotherapy and medication management needs to be improved. Further, quality of care for PTSD and depression varied by service branch, TRICARE region, and service member characteristics, suggesting the need to ensure that all service members receive high-quality care.
Chapter One
Introduction
Chapter Two
Methods
Chapter Three
Characteristics of Service Members in PTSD and Depression Cohorts, and Their Care Settings and Treatments
Chapter Four
Quality of Care for PTSD and Depression
Chapter Five
Variations in Care for PTSD and Depression Based on Patient Characteristics
Chapter Six
Summary and Recommendations
Appendix A
Technical Specifications for Administrative Data Quality Measures for PTSD
Appendix B
Technical Specifications for Administrative Data Quality Measures for Depression
Appendix C
Rules for Processing Administrative Data for Inpatient Stays and Outpatient Visits
This research was sponsored by Department of Defense's Centers of Excellence for Psychologic Health and Traumatic Brain Injury (DCoE) and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute.
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