Email UpdatesThis section describes the processes used to identify measures and map the measures to the Integration Framework. For the purposes of the IBHC Measures Atlas, measures are cited at the level of the instrument (e.g., questionnaire, checklist) to maintain the context and, in some cases, the validity of the measurement tool. When appropriate, specific submeasures that are relevant to integrated behavioral health care (e.g., specific questions or items) are listed as guidance for the reader.
The Search for Measures
Measures of integrated behavioral health care were identified through an environmental scan, which consisted of a literature review and consultation with subject matter experts. Key elements of the environmental scan were:
- Sources: Sources included quality measures clearinghouses; peer-reviewed scientific literature; and the “grey literature,” such as technical reports and working papers from scientific committees and government agencies.
- Search Methodology: The methodology was informed by methods used in the previously published AHRQ Care Coordination Measures Atlas. [1] Search terms and sources were updated for this IBHC Measures Atlas based on the definition of integrated behavioral health care and common terms under the topic of health care quality measurement.
- Limits: The search was limited to measures that were published or included in publications since 2001. Measures were included in the IBHC Measures Atlas if they were publicly available. Copyrighted or otherwise protected measures are included if they are available to the public at no cost.
An in-depth description of the methods of the search strategy is available in the Methodological Details.
Review of Measures and Mapping to the Integration Framework
Measures were included in the IBHC Measures Atlas based on a series of expert reviews. Measures selected for inclusion were mapped to relevant functional domains in the Integration Framework. Finally, reviewers conducted a usability and usefulness check, during which reviewers assessed the measures on the following three criteria:
- The degree to which each measure aligned with the measurement constructs;
- The number of functional domains addressed by a given measure; and
- The burden of using the measure.
Results of the usability and usefulness check were used to divide the final seventeen measures into two categories, (1) Core Measures and (2) Additional Measures, which are described below.
Measures of Integrated Behavioral Health Care
The IBHC Measures Atlas User’s Guide explains how to use the core measures to evaluate your integrated care program. It guides users through the major steps of program evaluation, including selecting a sample to survey and analyzing data. Download the IBHC Measures Atlas User’s Guide (PDF 0.45 MB).
Clinical Measures Tools
A literature search was conducted to find peer reviewed articles and reports that focus on the quality of integration between behavioral and physical health care settings. The literature search was limited to prevalent physical and mental health conditions that are commonly comorbid such as diabetes, cardiovascular disease, depression, and anxiety. Clinical health outcomes were used as the primary markers of quality.
The measures from the literature search were evaluated based on sensitivity, specificity, validity, and reliability. In order to be selected for the final list of clinical outcome measures, the measure was required to have at least 2 good psychometric properties. An in-depth description of the methods of the Clinical Literature Search is available in the Methodological Details. Below is the final list of clinical outcome measurement tools from the literature search:
Anxiety
Depression
- T8. Patient Health Questionnaire-9 (PDF 168.81kb)
The PHQ-9 is emerging as a standard depression instrument. National measures are increasingly based upon the PHQ-9.
Diabetes
Physical Health Conditions
- T13. Comprehensive Diabetes Care: Blood Pressure Control (<140/90 mm Hg) (PDF 154.77kb)
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.
- T14. Comprehensive Diabetes Care: Hemoglobin A1c (HbA1c) Control (<8.0%) (PDF 156.12kb)
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.
- T15. Controlling High Blood Pressure (PDF 156.69kb)
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.
- T17. Ischemic Vascular Disease (IVD): Blood Pressure Control (PDF 153.95kb)
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.
- T18. Multi-Dimensional Health Assessment Questionnaire (MDHAQ) (PDF 185.82kb)
© by Health Report Services, 615-479-5303, tedpincus@gmail.com
Substance Use/Substance Abuse
- T21. Alcohol Use Disorders Identification Test (PDF 62.51kb)
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.
- T23. Drug Abuse Screening Test (DAST) (PDF 85.90kb)
© 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.