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. 2018 Nov;27(11):1772-1787.
doi: 10.1002/hec.3800. Epub 2018 Jul 16.

The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England

Anika Reichert  1 , Rowena Jacobs  1
Affiliations

The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England

Anika Reichert et al. Health Econ. 2018 Nov.

Abstract

Recently, new emphasis was put on reducing waiting times in mental health services as there is an ongoing concern that longer waiting time for treatment leads to poorer health outcomes. However, little is known about delays within the mental health service system and its impact on patients. We explore the impact of waiting times on patient outcomes in the context of early intervention in psychosis (EIP) services in England from April 2012 to March 2015. We use the Mental Health Services Data Set and the routine outcome measure the Health of the Nation Outcome Scale. In a generalised linear regression model, we control for baseline outcomes, previous service use, and treatment intensity to account for possible endogeneity in waiting time. We find that longer waiting time is significantly associated with a deterioration in patient outcomes 12 months after acceptance for treatment for patients that are still in EIP care. Effects are strongest for waiting times longer than 3 months, and effect sizes are small to moderate. Patients with shorter treatment periods are not affected. The results suggest that policies should aim to reduce excessively long waits in order to improve outcomes for patients waiting for treatment for psychosis.

Keywords: mental health; psychosis; routine outcome measures; treatment intensity; waiting times.

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Figures

Figure 1
Figure 1
Study timeline with measurement points. EIP: early intervention in psychosis; HoNOS: Health of the Nation Outcome Scale
Figure 2
Figure 2
Histogram of HoNOS scores at baseline and follow‐up. EIP: early intervention in psychosis; HoNOS: Health of the Nation Outcome Scale
Figure 3
Figure 3
Descriptive statistics on waiting time
Figure 4
Figure 4
Box plots for HoNOS scores by waiting time intervals
See this image and copyright information in PMC

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