Tools

Clinical Outcome Measures

The AHRQ Academy conducted a literature search to find peer-reviewed articles and reports that focus on the quality of integration in behavioral and physical health care settings. The literature search was limited to common comorbid physical and mental health conditions, such as diabetes, cardiovascular disease, depression, and anxiety. Clinical health outcomes were used as the primary markers of quality.

The Academy first performed an extensive search for clinical outcome measures that assess the quality of integration in health care settings using the following resources: National Quality Measures Clearinghouse, Applied Social Sciences Index and Abstracts (ASSIA), Health and Psychosocial Instruments (HAPI), PsycINFO, and PubMed. They also conducted searches specifically focusing on financial outcomes and provider experience with integrated behavioral health care.

An initial review of articles from the searches suggested that no specific clinical outcome measures for evaluating quality of integrated care exist. Measures in the articles either focused on an individual behavioral health condition or the physical health outcome alone. A final search was then conducted to identify additional articles about the psychometric properties of the outcome measures based on survey instruments. 

The measures from the literature search were evaluated based on sensitivity, specificity, validity, and reliability. To be selected for the final list of clinical outcome measures, the measure had to have at least two good psychometric properties.

Anxiety

Generalized Anxiety Disorder Scale (GAD-7)
Generalized Anxiety Disorder Scale (GAD-2)

Depression

Zung Self-Rating Depression Scale
Patient Health Questionnaire-9
Patient Health Questionnaire-2
Hamilton Depression Rating Scale
Geriatric Depression Scale-30
Geriatric Depression Scale-15
Center of Epidemiological Studies-Depression (CES-D)

Diabetes

Measurement Specifications for Optimal Vascular Care
Optimal Diabetes Care Specifications

Physical Health Conditions

World Health Organization Quality of Life Brief Instrument
RAND 36-Item Health Survey (Short Form)
Multi-Dimensional Health Assessment Questionnaire (MDHAQ)

© by Health Report Services, 615-479-5303, tedpincus@gmail.com.

Ischemic Vascular Disease (IVD): Blood Pressure Control

Reproduced with permission from HEDIS 2015, Volume 2: Technical Specifications for Health Plans by the National Committee for Quality Assurance (NCQA). HEDIS® is a registered trademark of NCQA. Visit the NCQA Web site for additional resources and information.

Health Assessment Questionnaire-Disability Index (HAQ-DI)
Controlling High Blood Pressure

Reproduced with permission from HEDIS 2015, Volume 2: Technical Specifications for Health Plans by the National Committee for Quality Assurance (NCQA). HEDIS® is a registered trademark of NCQA. Visit NCQA Web site for additional resources and information.

Comprehensive Diabetes Care: Hemoglobin A1c (HbA1c) Control (<8.0%)

Reproduced with permission from HEDIS 2015, Volume 2: Technical Specifications for Health Plans by the National Committee for Quality Assurance (NCQA). HEDIS® is a registered trademark of NCQA. Visit NCQA Web site for additional resources and information.

Comprehensive Diabetes Care: Blood Pressure Control (<140/90 mm Hg)

Reproduced with permission from HEDIS 2015, Volume 2: Technical Specifications for Health Plans by the National Committee for Quality Assurance (NCQA). HEDIS® is a registered trademark of NCQA. Visit NCQA Web site for additional resources and information.

Arthritis Impact Measurement Scales (AIMS)

Substance Use/Substance Abuse

Alcohol Use Disorders Identification Test Consumption (AUDIT-C)
Alcohol Use Disorders Identification Test

Reproduced with permission of the publisher from Babor TF, Higgins-Biddle JC, Saunders JB, et al. The Alcohol Use Disorders Identification Test: guidelines for use in primary care, 2nd ed. Geneva, Switzerland: World Health Organization; 2013.

Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST)

Reproduced with permission of the World Health Organization.

Drug Abuse Screening Test (DAST)

© 1982 by Harvey A. Skinner, Ph.D., and the Centre for Addiction and Mental Health, Toronto, Canada. You may reproduce this instrument for noncommercial use (clinical, research, training purposes) as long as you credit the author, Dr. Harvey A. Skinner, York University, Toronto, Canada.

Visit the Overview of Measures included in the IBHC Measures Atlas for a full list of clinical outcome measures from the literature search.