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Service-level variation, patient-level factors, and treatment outcome in those seen by child mental health services

Edbrooke-Childs, J; Macdougall, A; Hayes, D; Jacob, J; Wolpert, M; Deighton, J; (2017) Service-level variation, patient-level factors, and treatment outcome in those seen by child mental health services. European Child & Adolescent Psychiatry 10.1007/s00787-016-0939-x. Green open access

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Abstract

Service comparison is a policy priority but is not without controversy. This paper aims to investigate the amount of service-level variation in outcomes in child mental health, whether it differed when examining outcomes unadjusted vs. adjusted for expected change over time, and which patient-level characteristics were associated with the difference observed between services. Multilevel regressions were used on N = 3256 young people (53% male, mean age 11.33 years) from 13 child mental health services. Outcome was measured using the parent-reported Strengths and Difficulties Questionnaire. The results showed there was 4-5% service-level variation in outcomes. Findings were broadly consistent across unadjusted vs. adjusted outcomes. Young people with autism or infrequent case characteristics (e.g., substance misuse) had greater risk of poor outcomes. Comparison of services with high proportions of young people with autism or infrequent case characteristics requiring specialist input needs particular caution as these young people may be at greater risk of poor outcomes.

Type: Article
Title: Service-level variation, patient-level factors, and treatment outcome in those seen by child mental health services
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00787-016-0939-x
Publisher version: http://doi.org/10.1007/s00787-016-0939-x
Language: English
Additional information: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Added value score, Adolescent mental health, Risk adjustment, Service-level variation, Treatment outcome
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/1539998
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