Expansion of Research Capability to Study Comparative Effectiveness in Complex Patients

Marisa Domino, Ph.D., Principal Investigator

Joseph P. Morrissey, Ph.D., Co-Investigator

Joel Farley, Ph.D., Co-Investigator

This subcontract between the Cecil G. Sheps Center for Heath Service Research, University of North Carolina at Chapel Hill, and NC Community Care Network, Inc. (NCCCN), is part of a teaming agreement to respond to RFA-HS-10-001, issued by the Agency for Health Care Research and Quality (AHRQ), entitled: “Expansion of Research Capability to Study Comparative Effectiveness in Complex Patients (R24).” The purpose of the project is to create a data infrastructure for comparative effectiveness research by linking health care data bases relevant to the care of complex patients and conducting a small research study as proof of concept that the infrastructure created is accessible and can be used to address important questions in comparative effectiveness research.

As part of this proposal, the Sheps Center will perform two sets of activities as described below:

  1. Collaborate with NCCNC staff to create an integrated database linking three data sets maintained by the NC Department of Health and Human Services: HEARTS (state psychiatric hospital admissions), IPRS (outpatient mental health services), and Medicaid claims. Sheps Center staff will provide technical assistance in identifying relevant mental health data elements in each data system, constructing composite measures of service use, and developing codebooks for the integrated database. We will assist in creating an administrative structure for managing the integrated database and making it available to the research community in NC and elsewhere.
  2. Conduct a small proof of concept study to confirm the accessibility and usability of the integrated data base. This study will focus on medical homes for patients with mental illness. We will explore variations in primary care visits, services received, and outcomes for patients with varying levels of psychiatric illness who are represented in the integrated database.

 Related Publications:
Domino ME, Beadles CA, Lichstein JC, Farley JF, Morrissey JP, Ellis AR, et al. Heterogeneity in the quality of care for patients with multiple chronic conditions by psychiatric comorbidity. Medicare Care. 2014;52 Suppl 3:S101-9.

Lichstein JC, Domino ME, Beadles CA, Ellis AR, Farley JF, Morrissey JP, et al. Use of medical homes by patients with comorbid physical and severe mental illness. Medicare Care. 2014;52 Suppl 3:S85-91.