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Cited by 49Psychiatric care and mental health servicesPrimary Care and Health OutcomesHealthcare Quality and Management

Healthcare system performance in continuity of care for patients with severe mental illness: a comparison of five European countries.

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Nicaise, Pablo, Giacco, Domenico, Soltmann, Bettina, Pfennig, Andrea, Miglietta, Elisabetta, Lasalvia, Antonio, Welbel, Marta, Wciórka, Jacek +3 more·2020·Health Policy
DOI 10.1016/j.healthpol.2019.11.004
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Abstract

Most healthcare systems struggle to provide continuity of care for people with chronic conditions, such as patients with severe mental illness. In this study, we reviewed how system features in two national health systems (NHS) - England and Veneto (Italy) - and three regulated-market systems (RMS) - Germany, Belgium, and Poland -, were likely to affect continuing care delivery and we empirically assessed system performance. 6418 patients recruited from psychiatric hospitals were followed up one year after admission. We collected data on their use of services and contact with professionals and assessed care continuity using indicators on the gap between hospital discharge and outpatient care, access to services, number of contacts with care professionals, satisfaction with care continuity, and helping alliance. Multivariate regressions were used to control for patients' characteristics. Important differences were found between healthcare systems. NHS countries had more effective longitudinal and cross-sectional care continuity than RMS countries, though Germany had similar results to England. Relational continuity seemed less affected by organisational mechanisms. This study provides straightforward empirical indicators for assessing healthcare system performance in care continuity. Despite systems' complexity, findings suggest that stronger regulation of care provision and financing at a local level should be considered for effective care continuity.

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  • Published qualitative studies on acute inpatients with psychosis were primarily conducted in a UK psychiatric context found to be very similar to the German system, making available data transferable to our research context.

    “Published studies were primarily conducted in a psychiatric context in the UK, which was found to be very similar to the German system (51), thus making available data transferable to our current research context.”

    From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [51]

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Authors
Nicaise, P., Giacco, D., Soltmann, B., Pfennig, A., Miglietta, E., Lasalvia, A., Welbel, M., Wciórka, J., Bird, V. J., Priebe, S., & Lorant, V.
Affiliations
  • UCLouvain (BE)
  • Queen Mary University of London (GB)
  • University Hospital Carl Gustav Carus (DE)
  • University of Verona (IT)
  • Azienda Ospedaliera Universitaria Integrata Verona (IT)
  • Institute of Psychiatry and Neurology (PL)
Corresponding author
Nicaise, Pablo
ORCID
Venue
Health Policy
Publisher
Elsevier BV
Published
2020-01
Volume
124
Issue
1
Pages
25-36
ISSN
0168-8510 (ISSN-L)
DOI
10.1016/j.healthpol.2019.11.004
OpenAlex
W2986077155
Cited by
49
References
73
Citations by year
2026: 3 · 2025: 8 · 2024: 5 · 2023: 9 · 2022: 6 · 2021: 15 · 2020: 3
FWCI
7.00
Type
journal article
Language
en
Open access
Licence
Locations
  • Health Policy (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DIAL (Catholic University of Leuven) (submittedVersion)
  • Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
  • Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion, other-oa)
  • Iris (University of Trento) (submittedVersion)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
Funders
European Commission
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
Keywords
continuity of care, severe mental illness, health system performance, National Health System, hospital discharge, outpatient care, care transitions, patient satisfaction, helping alliance, care coordination, health system regulation, health care financing, England, Veneto, Germany, Belgium, Poland
MeSH terms
Universal Health Care, Adult, Mental Disorders, Continuity of Patient Care, Europe, Female, Hospitalization, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Primary Health Care, Severity of Illness Index

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