Quality indicators for schizophrenia care: A scoping review

Abstract

Measuring quality of care is a critical first step towards improving the healthcare contributing to persistent poor outcomes experienced by many people living with schizophrenia. This scoping review aims to identify and characterize indicators for measuring the quality of care for people living with schizophrenia. We searched 6 academic databases, 4 grey literature databases, and 23 organization websites for documents containing quality indicators developed for or applied in a population with schizophrenia-spectrum disorders. We identified 119 unique documents, yielding 390 distinct quality indicators. Most measures were process indicators (68 %; n = 267) commonly reflecting safety (30 %; n = 118) and effectiveness (35 %; n = 136) domains of quality of care. Quality indicators included measures of primarily mental healthcare (77 %; n = 299), as well as physical healthcare (23 %; n = 91). Indicators reflected aspects of care related to service delivery, pharmacotherapy, assessments, resources and policies, psychological interventions, social and other interventions. Indicator development was notable for a lack of well-described validation and selection processes. Gaps in indicator availability for comorbid substance use, reproductive health, and healthcare equity were also identified. Results reflect a growing recognition of the importance of quality measurement in this population but highlight the need for prioritization of indicators to guide future quality measurement and improvement.