Continuing to produce better outcomes for consumers: The Access to Allied Psychological Services pro

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Continuing to produce better outcomes for
consumers The Access to Allied Psychological
Services projects

• General Practice NSW
• Mental Health Network Meeting
• 29 June 2009
• Bridget Bassilios, Justine Fletcher, Jane Pirkis,
  Kylie King, Fay Kohn
• Centre for Health Policy, Programs and Economics
• The University of Melbourne

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Presentation Outline

• General ATAPS update
• Perinatal Depression uptake
• Minimum Data Set
• Discussion / Questions

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• GENERAL ATAPS UPDATE

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Participation in ATAPS projects by GPs over
timeData downloaded May 2009
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Participation in ATAPS projects by allied health
professionals over timeData downloaded May 2009
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National referrals and sessions over
time(N153,922 and N602,405, respectively)Data
downloaded May 2009
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Proportion NSW/ACT referrals Data Downloaded May
2009
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Consumer Profile Data downloaded May 2009
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Consumer Profile contData downloaded May 2009
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Urban rural sessions over time
(N534,618)Data downloaded January 2009
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Proportion NSW / ACT sessions Data downloaded
May 2009
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Session profileData downloaded May 2009
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Consumer outcomesData downloaded May 2009

• Multiple outcome measures used across projects
• Pre- and post- outcome scores available for
  14,240 (12) consumers from 71 (50) projects
• Overall large positive effect size
• (83 projects show positive effects - 31 of
  projects showed large positive effects, 21
  showed medium positive effects, 48 showed small
  positive effects)

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Outcome data NSW Divisions Data Downloaded May
2009

• 23 of 35 (66) NSW Divisions entering useable
  data
• 5,144/41,477 (12) NSW consumers with pre- and
  post-test data
• Represents 36 (5,144/14,240) of consumers
  nationally in outcome data

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• PERINATAL DEPRESSION INITIATIVE UPDATE

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Uptake of Perinatal Depression Initiative by
ProvidersData downloaded May 2009
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National Perinatal Depression Initiative
consumer profile Data downloaded May 2009
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National Perinatal Depression Initiative
consumer profile cont Data downloaded May 2009
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National Perinatal Depression Initiative session
profileData downloaded May 2009
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• MINIMUM DATASET

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Minimum Data Set (MDS)

• Web-based data entry system
• Purpose is to obtain consistent and informative
  data from all ATAPS projects
• Data Collected
• Patient demographics
• Referral information
• Session information
• Pre post outcome data

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Use of MDS Data for Evaluation

• Track ATAPS uptake overtime
• Make comparisons between groups utilising ATAPS
  services, e.g. urban rural consumers
• Evaluation Questions
• What is the level of uptake (consumers, GPs,
  AHPs)?
• What are the sociodemographic characteristics of
  consumers?
• What are the clinical characteristics of
  consumers?
• What services are consumers receiving?
• Are these services improving the mental heath of
  consumers?
• What is the cost to the consumer?

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Accessing the MDS

• Username and password
• Username and password can be used by more than
  one staff member (at your Division) to view the
  minimum dataset at the same time
• only one person can make changes to the data at a
  time
• GPs and AHPs can use the username and password
  provided to the Division and enter the data
  themselves.
• The Minimum Dataset is accessed on the web at the
  following address http//boimhc.org/bin/view.
• Frequently Asked Questions link at the bottom of
  the home page
• Questions regarding the minimum dataset
  support_at_boimhc.org

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How Divisions can use the MDS Data Entry

• Methods of data entry
• Direct entry to MDS
• Upload data sets from Excel /Access etc
• Enter data as soon as it is available
• At the very least once per fortnight
• Complete data, by entering zero instead of
  leaving fields blank

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Changes to MDS
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Changes to MDS
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Outcome measures reminder
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How Divisions can use the MDS Reporting

• Each division can view only their own data
• Automatically generate a series of Individual
  Division Reports.
• Compare with National Data
• Compare with de-identified, aggregated peer
  divisions
• Enables Divisions to generate a series of tables
  for the MDS fields, including both consumer and
  session data.
• These reports present data on consumers referred,
  and sessions provided, in a given period.

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MDS Data for Individual Division Evaluations

• Download data and import into an alternative
  program
• Use excel or SPSS
• Use for internal reporting and feedback to
  stakeholders
• Three sets of data to download
• Patient
• Referral, including outcome measures
• Session

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MDS Generated TablesConsumer Reporting

• Year of birth
• Gender
• Language at home
• English level
• Aboriginal
• Torres S.I.
• Low income

• Education
• Lives alone
• ICD-10 diagnostic categories
• Medication
• Strategies referred for
• Previous care

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MDS Generated TablesSession Reporting

• Duration
• Individual / Group

• Strategies provided
• Co-payment

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Data entry tips

• Each consumer should retain the same patient
  key for all referrals
• A new referral number is allocated after 12
  sessions
• When entering DASS scores enter either total or
  subscale scores. NOT BOTH
• HADS, now use HADS dep or anx, the subscale
  scores will be automatically generated once item
  level data has been entered
• If one lump sum copayment is taken for numerous
  sessions it should be divided by the number of
  sessions, and each session entered with the
  corresponding amount.
• EG 120 in one payment for six sessions. The MDS
  should reflect that each sessions copayment was
  20

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Rationale for Evaluation

• Accountability
• Opportunities for improvement
• Showcasing high levels of achievement
• Making a case for ongoing support
• Furthering knowledge about delivery of primary
  mental health care

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Interim Evaluation Reports Evaluation Support

• Reports available at http//boimhc.org
• Jane Pirkis
• Bridget Bassilios
• Justine Fletcher
• Fay Kohn
• Kylie King
• Grant Blashki
• Philip Burgess
• Evaluation support available via email
• support_at_boimhc.org

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List of Journal Publications

• Bassilios B, Fletcher J, Pirkis J, Kohn F,
  Blashki G, Burgess P. (2008). Evaluation of the
  Better Outcomes in Mental Health Care program.
  APS Conference Proceedings, 16-20.
• Fletcher J, Bassilios B, Kohn F, Naccarella L,
  Blashki G, Burgess P, Pirkis J (2008). Meeting
  demand for psychological services by people with
  depression and anxiety Recent developments in
  primary mental health care. Medical Journal of
  Australia. 188 (12) S107-S109.
• Hickie I, Pirkis J, Blashki G, Groom G, Davenport
  T. General practitioners' response to depression
  and anxiety in the Australian community A
  preliminary analysis. Medical Journal of
  Australia 2004181(7)S15-S20.
• Kohn F, Pirkis J, Morley B, Naccarella L, Blashki
  G (2008). Utilization of findings from the
  evaluation of a major primary mental health care
  initiative in Australia. Evaluation Journal of
  Australia
• Morley B, Pirkis J, Naccarella L, Kohn F, Blashki
  G, Burgess P. Improving access to and outcomes
  from mental health care for rural Australians.
  Australian Journal of Rural Health 2007
  15(5)304-12.
• Morley B, Pirkis J, Sanderson K, Burgess P, Kohn
  F, Naccarella L, et al. Better outcomes in mental
  health care The impact of different models of
  psychological service provision on consumer
  outcomes. Australian and New Zealand Journal of
  Psychiatry 200741142-149.
• Naccarella L, Pirkis J, Kohn F, Morley B, Burgess
  P, Blashki G. Building evaluation capacity
  Definitional and practical implications from an
  Australian case study. Evaluation and Program
  Planning , 30, 231-236.
• Pirkis J, Kohn F, Morley B, Burgess P, Blashki G.
  Better Outcomes in Mental Healthcare? Primary
  Care Mental Health 20042141-149.
• Pirkis J, Morley B, Kohn F, Blashki G, Burgess P,
  Headey A. Improving access to evidence-based
  mental health care General practitioners and
  allied health professionals collaborate. Primary
  Care Psychiatry 20049(4)125-130.
• Pirkis J, Stokes D, Morley B, Kohn F, Mathews R,
  Naccarella L, et al. Impacts of Australia's
  Better Outcomes in Mental Health Care program for
  psychologists. Australian Psychologist
  200641(3)152-159.