The quality of mental health care for people with bipolar disorders in the Italian mental health system: the QUADIM project
Background The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorde...
Saved in:
| Published in | BMC psychiatry Vol. 23; no. 1; pp. 424 - 13 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BioMed Central
13.06.2023
BioMed Central Ltd BMC |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1471-244X 1471-244X |
| DOI | 10.1186/s12888-023-04921-7 |
Cover
| Abstract | Background
The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo).
Methods
Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions.
Results
29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had
≥
1 outpatient/day-care contacts and 88% had
≥
1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26–1.44): 1.18 (1.07–1.29) in females, 1.60 (1.45–1.77) in males. Heterogeneity across areas was considerable in both cohorts.
Conclusions
We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. |
|---|---|
| AbstractList | Background The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Methods Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. Results 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had [greater than or equal to] 1 outpatient/day-care contacts and 88% had [greater than or equal to] 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26-1.44): 1.18 (1.07-1.29) in females, 1.60 (1.45-1.77) in males. Heterogeneity across areas was considerable in both cohorts. Conclusions We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. Keywords: Healthcare utilization databases, Bipolar disorders, Quality of mental health care, Treatment gap, Clinical pathways, Mental health care, Real-world, Healthcare research, Public health, Healthcare services The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26-1.44): 1.18 (1.07-1.29) in females, 1.60 (1.45-1.77) in males. Heterogeneity across areas was considerable in both cohorts. We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. Abstract Background The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Methods Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. Results 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26–1.44): 1.18 (1.07–1.29) in females, 1.60 (1.45–1.77) in males. Heterogeneity across areas was considerable in both cohorts. Conclusions We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. BackgroundThe assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo).MethodsThirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions.Results29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26–1.44): 1.18 (1.07–1.29) in females, 1.60 (1.45–1.77) in males. Heterogeneity across areas was considerable in both cohorts.ConclusionsWe found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. Background The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Methods Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. Results 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26–1.44): 1.18 (1.07–1.29) in females, 1.60 (1.45–1.77) in males. Heterogeneity across areas was considerable in both cohorts. Conclusions We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had [greater than or equal to] 1 outpatient/day-care contacts and 88% had [greater than or equal to] 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26-1.44): 1.18 (1.07-1.29) in females, 1.60 (1.45-1.77) in males. Heterogeneity across areas was considerable in both cohorts. We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo).BACKGROUNDThe assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo).Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions.METHODSThirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions.29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26-1.44): 1.18 (1.07-1.29) in females, 1.60 (1.45-1.77) in males. Heterogeneity across areas was considerable in both cohorts.RESULTS29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26-1.44): 1.18 (1.07-1.29) in females, 1.60 (1.45-1.77) in males. Heterogeneity across areas was considerable in both cohorts.We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health.CONCLUSIONSWe found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. |
| ArticleNumber | 424 |
| Audience | Academic |
| Author | Di Fiandra, Teresa Lora, Antonio Scondotto, Salvatore Giordani, Cristina Allevi, Liliana Carle, Flavia Sanza, Michele Ferrara, Lucia Gaddini, Andrea Saponaro, Alessio Corrao, Giovanni Tozzi, Valeria D D’Avanzo, Barbara Caggiu, Giulia Barbato, Angelo Monzio Compagnoni, Matteo |
| Author_xml | – sequence: 1 givenname: Barbara surname: D’Avanzo fullname: D’Avanzo, Barbara organization: Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS – sequence: 2 givenname: Angelo surname: Barbato fullname: Barbato, Angelo organization: Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS – sequence: 3 givenname: Matteo surname: Monzio Compagnoni fullname: Monzio Compagnoni, Matteo email: matteo.monziocompagnoni@unimib.it organization: National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca – sequence: 4 givenname: Giulia surname: Caggiu fullname: Caggiu, Giulia organization: National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Department of Mental Health and Addiction Services, ASST Lecco – sequence: 5 givenname: Liliana surname: Allevi fullname: Allevi, Liliana organization: Department of Mental Health and Addiction Services, ASST Lecco – sequence: 6 givenname: Flavia surname: Carle fullname: Carle, Flavia organization: National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Center of Epidemiology and Biostatistics, Polytechnic University of Marche – sequence: 7 givenname: Teresa surname: Di Fiandra fullname: Di Fiandra, Teresa organization: National Institute of Health – sequence: 8 givenname: Lucia surname: Ferrara fullname: Ferrara, Lucia organization: Centre of Research on Health and Social Care Management, SDA Bocconi School of Management (Bocconi University – sequence: 9 givenname: Andrea surname: Gaddini fullname: Gaddini, Andrea organization: Agency for Public Health, Lazio Region – sequence: 10 givenname: Michele surname: Sanza fullname: Sanza, Michele organization: Department of Mental Health and Substance Abuse, Local Health Trust of Romagna – sequence: 11 givenname: Alessio surname: Saponaro fullname: Saponaro, Alessio organization: General Directorate of Health and Social Policies, Emilia-Romagna Region – sequence: 12 givenname: Salvatore surname: Scondotto fullname: Scondotto, Salvatore organization: National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Department of Health Services and Epidemiological Observatory, Regional Health Authority, Sicily Region – sequence: 13 givenname: Valeria D surname: Tozzi fullname: Tozzi, Valeria D organization: Centre of Research on Health and Social Care Management, SDA Bocconi School of Management (Bocconi University – sequence: 14 givenname: Cristina surname: Giordani fullname: Giordani, Cristina organization: Department of Health Planning, Italian Health Ministry – sequence: 15 givenname: Giovanni surname: Corrao fullname: Corrao, Giovanni organization: National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca – sequence: 16 givenname: Antonio surname: Lora fullname: Lora, Antonio organization: National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Department of Mental Health and Addiction Services, ASST Lecco |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37312076$$D View this record in MEDLINE/PubMed |
| BookMark | eNp9kl1r2zAYhc3oWD-2P7CLIdhNb9zpw5bk3YzQfQU6xqCF3QlZfpUo2JYrORthf35y0q5NGMUIi1fPOfYR5zQ76n0PWfaa4AtCJH8XCZVS5piyHBcVJbl4lp2QQpCcFsXPo0f74-w0xhXGRMiSvMiOmWCEYsFPsj_XS0C3a926cYO8RR30o27REnQ7LpHRAZD1AQ3ghxbQb5eGtRt8qwNqXPShgRCR69GYbOZJ6XR_4BE3cYTu_Zb4cTP7OP-GhuBXYMaX2XOr2wiv7t5n2c3nT9eXX_Or71_ml7Or3HAsx5xZwZtay8pKXJbCyILjSlSFkbrRmFrCy7pOZNMAFEaUAmMpDSmZNFVVEc7OsvnOt_F6pYbgOh02ymuntgMfFkqH0ZkWVMVYyQWFgtV1QaiVAkwJlvK0Kstp8vqw8xrWdQeNSVGDbvdM9096t1QL_0sRTDmRrEwO53cOwd-uIY6qc9FA2-oe_DoqKmkpU0AiEvr2AF35dejTXU2UwEwWmD5QC50SuN769GEzmaqZKGnFuGRFoi7-Q6Wngc6ZVCzr0nxP8OZx0n8R77uTALkDTPAxBrDKuFGPzk_BXZsSq6mmaldTlf5UbWuqpmD0QHrv_qSI7UQxwf0CwsNtPKH6Cypt-C4 |
| CitedBy_id | crossref_primary_10_1177_00207640241278291 crossref_primary_10_1186_s13033_023_00603_9 crossref_primary_10_1080_09540261_2024_2391800 crossref_primary_10_3389_fpsyt_2024_1358775 crossref_primary_10_3390_jcm13072073 crossref_primary_10_1177_11786329241229950 |
| Cites_doi | 10.1136/bmjopen-2014-007140 10.1007/s00127-008-0378-1 10.1001/archpsyc.62.6.629 10.1177/0020764016631368 10.1016/S0140-6736(20)31544-0 10.1016/j.euroneuro.2011.07.018 10.1007/s12325-022-02112-6 10.1111/acps.12408 10.1007/s00127-021-02114-9 10.1136/bmj.327.7414.557 10.1186/s40345-018-0140-x 10.1097/YCO.0000000000000620 10.1016/S2215-0366(19)30298-6 10.5694/mja15.00447 10.1377/hlthaff.2016.0027 10.24095/hpcdp.31.3.07 10.1192/bjp.bp.117.202606 10.1017/S0033291703001399 10.1055/s-0034-1398506 10.1017/S2045796016000743 10.1007/s11920-017-0780-z 10.1016/S0163-8343(99)00057-2 10.1111/bdi.12423 10.1007/s11920-014-0499-z 10.1016/j.jpsychires.2020.03.015 10.1177/0004867417695889 10.1186/s13033-018-0223-1 10.1001/archgenpsychiatry.2011.12 10.1111/bdi.12025 10.1016/j.jad.2020.12.151 10.1016/j.jad.2014.11.058 10.1111/bdi.12234 10.1111/bdi.12609 10.1017/S0033291719001053 10.1017/S2045796022000014 10.1176/ps.62.9.pss6209_1079 10.1001/archpsyc.60.4.402 10.1097/NMD.0000000000000139 10.1016/S2215-0366(18)30253-0 10.1111/bdi.12593 |
| ContentType | Journal Article |
| Copyright | The Author(s) 2023 2023. The Author(s). COPYRIGHT 2023 BioMed Central Ltd. 2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
| Copyright_xml | – notice: The Author(s) 2023 – notice: 2023. The Author(s). – notice: COPYRIGHT 2023 BioMed Central Ltd. – notice: 2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
| DBID | C6C AAYXX CITATION NPM 3V. 7TK 7X7 7XB 88E 88G 8FI 8FJ 8FK ABUWG AFKRA AZQEC BENPR CCPQU DWQXO FYUFA GHDGH GNUQQ K9. M0S M1P M2M PHGZM PHGZT PIMPY PJZUB PKEHL PPXIY PQEST PQQKQ PQUKI PSYQQ Q9U 7X8 5PM DOA |
| DOI | 10.1186/s12888-023-04921-7 |
| DatabaseName | Springer Nature OA Free Journals CrossRef PubMed ProQuest Central (Corporate) Neurosciences Abstracts Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) Psychology Database (Alumni) Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) ProQuest Central ProQuest Central UK/Ireland ProQuest Central Essentials ProQuest Central ProQuest One Community College ProQuest Central Korea Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Central Student ProQuest Health & Medical Complete (Alumni) ProQuest Health & Medical Collection Medical Database Psychology Database Proquest Central Premium ProQuest One Academic (New) Publicly Available Content Database ProQuest Health & Medical Research Collection ProQuest One Academic Middle East (New) ProQuest One Health & Nursing ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic ProQuest One Academic UKI Edition ProQuest One Psychology ProQuest Central Basic MEDLINE - Academic PubMed Central (Full Participant titles) DOAJ Directory of Open Access Journals |
| DatabaseTitle | CrossRef PubMed Publicly Available Content Database ProQuest One Psychology ProQuest Central Student ProQuest One Academic Middle East (New) ProQuest Central Essentials ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest One Health & Nursing ProQuest Central Health Research Premium Collection Health and Medicine Complete (Alumni Edition) ProQuest Central Korea Health & Medical Research Collection ProQuest Central (New) ProQuest Medical Library (Alumni) ProQuest Central Basic ProQuest One Academic Eastern Edition ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Psychology Journals (Alumni) Neurosciences Abstracts ProQuest Hospital Collection (Alumni) ProQuest Health & Medical Complete ProQuest Medical Library ProQuest Psychology Journals ProQuest One Academic UKI Edition ProQuest One Academic ProQuest One Academic (New) ProQuest Central (Alumni) MEDLINE - Academic |
| DatabaseTitleList | PubMed Publicly Available Content Database MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: C6C name: Springer Nature OA Free Journals url: http://www.springeropen.com/ sourceTypes: Publisher – sequence: 2 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 3 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 4 dbid: BENPR name: ProQuest Central url: http://www.proquest.com/pqcentral?accountid=15518 sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1471-244X |
| EndPage | 13 |
| ExternalDocumentID | oai_doaj_org_article_9335672e43bb412f87ec5ef26ef29f62 PMC10261835 A752936834 37312076 10_1186_s12888_023_04921_7 |
| Genre | Journal Article |
| GeographicLocations | Italy Western Europe |
| GeographicLocations_xml | – name: Italy – name: Western Europe |
| GrantInformation_xml | – fundername: Università degli Studi di Milano - Bicocca – fundername: ; |
| GroupedDBID | --- 0R~ 23N 2WC 53G 5VS 6J9 7X7 88E 8FI 8FJ AAFWJ AAJSJ AASML ABDBF ABIVO ABUWG ACGFO ACGFS ACIHN ACPRK ACUHS ADBBV ADRAZ ADUKV AEAQA AENEX AFKRA AFPKN AHBYD AHMBA AHYZX ALMA_UNASSIGNED_HOLDINGS AMKLP AMTXH AOIJS AZQEC BAPOH BAWUL BCNDV BENPR BFQNJ BMC BPHCQ BVXVI C6C CCPQU CS3 DIK DWQXO E3Z EAD EAP EAS EBD EBLON EBS EMB EMK EMOBN ESX F5P FYUFA GNUQQ GROUPED_DOAJ GX1 HMCUK HYE IAO IHR INH INR IPY ITC KQ8 M1P M2M M48 M~E O5R O5S OK1 OVT P2P PGMZT PHGZM PHGZT PIMPY PJZUB PPXIY PQQKQ PROAC PSQYO PSYQQ PUEGO RBZ RNS ROL RPM RSV SMD SOJ SV3 TR2 TUS UKHRP W2D WOQ WOW XSB AAYXX ALIPV CITATION NPM PMFND 3V. 7TK 7XB 8FK K9. PKEHL PQEST PQUKI Q9U 7X8 5PM |
| ID | FETCH-LOGICAL-c608t-3f76dba89f80557c84609794c8ada02f165bb608ddee4c7570088c1538c999163 |
| IEDL.DBID | M48 |
| ISSN | 1471-244X |
| IngestDate | Wed Aug 27 01:26:51 EDT 2025 Thu Aug 21 18:37:14 EDT 2025 Thu Sep 04 22:02:38 EDT 2025 Sat Jul 26 00:25:32 EDT 2025 Tue Jun 17 21:48:01 EDT 2025 Tue Jun 10 20:41:27 EDT 2025 Thu Apr 03 07:04:39 EDT 2025 Thu Apr 24 23:07:03 EDT 2025 Tue Jul 01 00:26:24 EDT 2025 Sat Sep 06 07:21:57 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 1 |
| Keywords | Mental health care Healthcare services Healthcare utilization databases Real-world Healthcare research Treatment gap Clinical pathways Bipolar disorders Quality of mental health care Public health |
| Language | English |
| License | 2023. The Author(s). Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c608t-3f76dba89f80557c84609794c8ada02f165bb608ddee4c7570088c1538c999163 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 |
| OpenAccessLink | http://journals.scholarsportal.info/openUrl.xqy?doi=10.1186/s12888-023-04921-7 |
| PMID | 37312076 |
| PQID | 2827038402 |
| PQPubID | 44775 |
| PageCount | 13 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_9335672e43bb412f87ec5ef26ef29f62 pubmedcentral_primary_oai_pubmedcentral_nih_gov_10261835 proquest_miscellaneous_2825809717 proquest_journals_2827038402 gale_infotracmisc_A752936834 gale_infotracacademiconefile_A752936834 pubmed_primary_37312076 crossref_citationtrail_10_1186_s12888_023_04921_7 crossref_primary_10_1186_s12888_023_04921_7 springer_journals_10_1186_s12888_023_04921_7 |
| ProviderPackageCode | CITATION AAYXX |
| PublicationCentury | 2000 |
| PublicationDate | 2023-06-13 |
| PublicationDateYYYYMMDD | 2023-06-13 |
| PublicationDate_xml | – month: 06 year: 2023 text: 2023-06-13 day: 13 |
| PublicationDecade | 2020 |
| PublicationPlace | London |
| PublicationPlace_xml | – name: London – name: England |
| PublicationTitle | BMC psychiatry |
| PublicationTitleAbbrev | BMC Psychiatry |
| PublicationTitleAlternate | BMC Psychiatry |
| PublicationYear | 2023 |
| Publisher | BioMed Central BioMed Central Ltd BMC |
| Publisher_xml | – name: BioMed Central – name: BioMed Central Ltd – name: BMC |
| References | LH Lomholt (4921_CR15) 2019; 7 F Jacobi (4921_CR31) 2004; 34 JF Hayes (4921_CR5) 2015; 131 R Jain (4921_CR14) 2022; 39 A Lora (4921_CR35) 2011; 62 KR Merikangas (4921_CR7) 2011; 68 RS McIntyre (4921_CR10) 2020; 396 A Lora (4921_CR22) 2016; 28 A Rosen (4921_CR45) 2020; 33 AJ Ferrari (4921_CR6) 2016; 18 LN Yatham (4921_CR24) 2013; 15 S-H Bih (4921_CR30) 2008; 43 A Parabiaghi (4921_CR39) 2015; 48 HA Pincus (4921_CR3) 2016; 35 JF Hayes (4921_CR43) 2017; 211 JPT Higgins (4921_CR27) 2003; 327 PS Wang (4921_CR36) 2005; 62 A Karanti (4921_CR41) 2015; 174 ML Wainberg (4921_CR2) 2017; 19 F Colom (4921_CR37) 2003; 60 G Corrao (4921_CR20) 2021 LV Kessing (4921_CR9) 2018; 20 J Unützer (4921_CR44) 2000; 22 SP Rosenberg (4921_CR46) 2015; 203 O Zivanovic (4921_CR40) 2017; 51 AG Bulloch (4921_CR8) 2011; 31 A Fioritti (4921_CR18) 2014; 202 4921_CR28 CS Humpston (4921_CR32) 2021; 282 E Joas (4921_CR34) 2020; 50 A Lora (4921_CR19) 2022; 31 KAS Davis (4921_CR13) 2020; 7 A Carlborg (4921_CR29) 2015; 17 M Bauer (4921_CR12) 2018; 5 C Barbui (4921_CR17) 2018; 12 4921_CR23 National Collaborating Centre for Mental Health (UK) (4921_CR25) 2014 AM Kilbourne (4921_CR1) 2018; 17 4921_CR26 A Barbato (4921_CR11) 2016; 62 G Corrao (4921_CR21) 2015; 5 HU Wittchen (4921_CR33) 2011; 21 C Miller (4921_CR42) 2014; 16 A Lora (4921_CR16) 2017; 26 H He (4921_CR4) 2020; 125 LN Yatham (4921_CR38) 2018; 20 |
| References_xml | – volume: 5 start-page: e007140 year: 2015 ident: 4921_CR21 publication-title: BMJ Open doi: 10.1136/bmjopen-2014-007140 – volume: 43 start-page: 860 year: 2008 ident: 4921_CR30 publication-title: Soc Psychiatry Psychiatr Epidemiol doi: 10.1007/s00127-008-0378-1 – volume: 62 start-page: 629 year: 2005 ident: 4921_CR36 publication-title: Arch Gen Psychiatry doi: 10.1001/archpsyc.62.6.629 – volume: 62 start-page: 334 year: 2016 ident: 4921_CR11 publication-title: Int J Soc Psychiatry doi: 10.1177/0020764016631368 – volume: 396 start-page: 1841 year: 2020 ident: 4921_CR10 publication-title: Lancet Lond Engl doi: 10.1016/S0140-6736(20)31544-0 – ident: 4921_CR23 – volume: 21 start-page: 655 year: 2011 ident: 4921_CR33 publication-title: Eur Neuropsychopharmacol J Eur Coll Neuropsychopharmacol doi: 10.1016/j.euroneuro.2011.07.018 – volume: 39 start-page: 2578 year: 2022 ident: 4921_CR14 publication-title: Adv Ther doi: 10.1007/s12325-022-02112-6 – volume: 131 start-page: 417 year: 2015 ident: 4921_CR5 publication-title: Acta Psychiatr Scand doi: 10.1111/acps.12408 – year: 2021 ident: 4921_CR20 publication-title: Soc Psychiatry Psychiatr Epidemiol doi: 10.1007/s00127-021-02114-9 – volume: 327 start-page: 557 year: 2003 ident: 4921_CR27 publication-title: BMJ doi: 10.1136/bmj.327.7414.557 – volume: 7 start-page: 6 year: 2019 ident: 4921_CR15 publication-title: Int J Bipolar Disord doi: 10.1186/s40345-018-0140-x – volume: 33 start-page: 375 year: 2020 ident: 4921_CR45 publication-title: Curr Opin Psychiatry doi: 10.1097/YCO.0000000000000620 – volume: 7 start-page: 363 year: 2020 ident: 4921_CR13 publication-title: Lancet Psychiatry doi: 10.1016/S2215-0366(19)30298-6 – volume: 203 start-page: 328 year: 2015 ident: 4921_CR46 publication-title: Med J Aust doi: 10.5694/mja15.00447 – volume: 35 start-page: 1000 year: 2016 ident: 4921_CR3 publication-title: Health Aff Proj Hope doi: 10.1377/hlthaff.2016.0027 – volume: 31 start-page: 129 year: 2011 ident: 4921_CR8 publication-title: Chronic Dis Inj Can doi: 10.24095/hpcdp.31.3.07 – volume: 211 start-page: 175 year: 2017 ident: 4921_CR43 publication-title: Br J Psychiatry J Ment Sci doi: 10.1192/bjp.bp.117.202606 – volume: 34 start-page: 597 year: 2004 ident: 4921_CR31 publication-title: Psychol Med doi: 10.1017/S0033291703001399 – volume: 48 start-page: 89 year: 2015 ident: 4921_CR39 publication-title: Pharmacopsychiatry doi: 10.1055/s-0034-1398506 – volume: 26 start-page: 383 year: 2017 ident: 4921_CR16 publication-title: Epidemiol Psychiatr Sci doi: 10.1017/S2045796016000743 – volume: 19 start-page: 28 year: 2017 ident: 4921_CR2 publication-title: Curr Psychiatry Rep doi: 10.1007/s11920-017-0780-z – volume: 22 start-page: 1 year: 2000 ident: 4921_CR44 publication-title: Gen Hosp Psychiatry doi: 10.1016/S0163-8343(99)00057-2 – volume: 18 start-page: 440 year: 2016 ident: 4921_CR6 publication-title: Bipolar Disord doi: 10.1111/bdi.12423 – volume: 16 start-page: 499 year: 2014 ident: 4921_CR42 publication-title: Curr Psychiatry Rep doi: 10.1007/s11920-014-0499-z – volume: 125 start-page: 96 year: 2020 ident: 4921_CR4 publication-title: J Psychiatr Res doi: 10.1016/j.jpsychires.2020.03.015 – volume: 51 start-page: 886 year: 2017 ident: 4921_CR40 publication-title: Aust N Z J Psychiatry doi: 10.1177/0004867417695889 – volume: 12 start-page: 43 year: 2018 ident: 4921_CR17 publication-title: Int J Ment Health Syst doi: 10.1186/s13033-018-0223-1 – volume: 68 start-page: 241 year: 2011 ident: 4921_CR7 publication-title: Arch Gen Psychiatry doi: 10.1001/archgenpsychiatry.2011.12 – volume: 15 start-page: 1 year: 2013 ident: 4921_CR24 publication-title: Bipolar Disord doi: 10.1111/bdi.12025 – volume: 282 start-page: 426 year: 2021 ident: 4921_CR32 publication-title: J Affect Disord doi: 10.1016/j.jad.2020.12.151 – volume: 174 start-page: 303 year: 2015 ident: 4921_CR41 publication-title: J Affect Disord doi: 10.1016/j.jad.2014.11.058 – volume: 17 start-page: 76 year: 2015 ident: 4921_CR29 publication-title: Bipolar Disord doi: 10.1111/bdi.12234 – volume: 20 start-page: 97 year: 2018 ident: 4921_CR38 publication-title: Bipolar Disord doi: 10.1111/bdi.12609 – volume: 50 start-page: 1043 year: 2020 ident: 4921_CR34 publication-title: Psychol Med doi: 10.1017/S0033291719001053 – volume: 31 start-page: e15 year: 2022 ident: 4921_CR19 publication-title: Epidemiol Psychiatr Sci doi: 10.1017/S2045796022000014 – ident: 4921_CR28 – volume: 28 start-page: 728 year: 2016 ident: 4921_CR22 publication-title: Int J Qual Health Care J Int Soc Qual Health Care – ident: 4921_CR26 – volume: 62 start-page: 1079 year: 2011 ident: 4921_CR35 publication-title: Psychiatr Serv Wash DC doi: 10.1176/ps.62.9.pss6209_1079 – volume: 60 start-page: 402 year: 2003 ident: 4921_CR37 publication-title: Arch Gen Psychiatry doi: 10.1001/archpsyc.60.4.402 – volume-title: Bipolar disorder: the NICE Guideline on the Assessment and Management of bipolar disorder in adults, children and young people in primary and secondary care year: 2014 ident: 4921_CR25 – volume: 202 start-page: 425 year: 2014 ident: 4921_CR18 publication-title: J Nerv Ment Dis doi: 10.1097/NMD.0000000000000139 – volume: 5 start-page: 930 year: 2018 ident: 4921_CR12 publication-title: Lancet Psychiatry doi: 10.1016/S2215-0366(18)30253-0 – volume: 17 start-page: 30 year: 2018 ident: 4921_CR1 publication-title: World Psychiatry Off J World Psychiatr Assoc WPA – volume: 20 start-page: 9 year: 2018 ident: 4921_CR9 publication-title: Bipolar Disord doi: 10.1111/bdi.12593 |
| SSID | ssj0017851 |
| Score | 2.4092135 |
| Snippet | Background
The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon,... The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using... Background The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon,... BackgroundThe assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon,... Abstract Background The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains... |
| SourceID | doaj pubmedcentral proquest gale pubmed crossref springer |
| SourceType | Open Website Open Access Repository Aggregation Database Index Database Enrichment Source Publisher |
| StartPage | 424 |
| SubjectTerms | Antidepressants Antipsychotics Bipolar disorder Bipolar disorders Care and treatment Clinical pathways Evaluation Health care Health services utilization Healthcare utilization databases Hospitals Intervention Lithium Medical care Medicine Medicine & Public Health Mental disorders Mental health Mental health care Mortality Patient outcomes Patients Prescriptions Psychiatric services Psychiatry Psychotherapy Quality management Quality of mental health care Statistical analysis Treatment gap |
| SummonAdditionalLinks | – databaseName: DOAJ Directory of Open Access Journals dbid: DOA link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1LbxMxELaqHhAXxKuwUCojIXFore7T9nIrhaqtVE6t1JtlT2wRCW2qJj0g_jwztjd0g4ALinKJZ7N-zIy_scefGXuHUZXrrdMC0TSItnMgXA1aqM4p7z24mY9Zvl_k6VV7ft1d37vqi3LCEj1w6rhDDLg7qWrfNs61VR208tD5UEv89iF537Ivx2Aq7x_QlfPjERktD5fohVEjcH4SiIjrSqjJNBTZ-n_3yfcmpc2EyY1d0zgZnTxmjzKK5Eep9k_Ylh-esgcXeZ_8GfuBo8_TecnvfBF4YvDn6dAjp2wvjmCVp_RxTmux3M1vKMrls0zHueTzgSM65GeruBSy8R-JAfpDlEBU_OnsgudFnefs6uTz5fGpyNcsCJClXokmKDlzVvdBEyEXICIpezRT0HZmyzpUsnMOJdER-hYUEeJrDeQpIaLLZodtD4vBv2S8AhWqYHvvQGEkpC1-ytJC01ogarCCVWOvG8gc5HQVxjcTYxEtTRopgyNl4kgZVbD99TM3iYHjr9IfaTDXksSeHX9AnTJZp8y_dKpg70kVDNk4Vg9sPqqAjSS2LHOkOkRJUjdtwXYnkmibMC0elclk37A0GOSim8XAGt_zdl1MT1K-2-AXd1Gm00TvhQ16kXRv3aRGNVVdKlkwPdHKSZunJcP8a2QOryjiRsxdsINRgX_V68-d-up_dOpr9rCOBki8l7tse3V7598goFu5vWi7PwHXtkT5 priority: 102 providerName: Directory of Open Access Journals – databaseName: Health & Medical Collection dbid: 7X7 link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1Lb9QwELagSIgLKu_QgoyExAGsJk5iO71U5VG1SOVEpb1Z8cSBlVCydLcHxJ9nxnFSsogq2ks8WcXxzPgbe_wNY68xqnJV7YxANA2iKB0IJ8EIXTrtvQfX-JDl-0WdXhSfF-UiLritY1rl6BODo256oDXyAwwNUDkxHJFHq5-CqkbR7mosoXGb3ckQiVDpBr2YAq5QeH48KGPUwRp9MeoFzlICcbHMhJ5NRoGz_1_P_NfUtJ02ubV3Gqakk112P2JJfjwM_gN2y3cP2d3zuFv-iP1GHeDDqclfvG_5wOPPh6OPnHK-OEJWPiSRc1qR5W65oliXN5GUc82XHUeMyM82YUFk6z8GHujDIIHY-OPZOY9LO4_Zxcmnrx9ORSy2IEClZiPyVqvG1aZqDdFyAeKStEJjBVM3dSrbTJXOoSS6Q1-AJlp8Y4D8JQSMmT9hO13f-WeMZ6DbrK0r70BjPGRqvNK0hryogQjCEpaNX91CZCKnghg_bIhIjLLDSFkcKRtGyuqEvZ2eWQ08HDdKv6fBnCSJQzvc6C-_2WiStsrzUmnpi9y5IpOt0R5K30qFv6pVMmFvSBUsWTq-HtTxwAJ2kjiz7LEuESspkxcJ259JooXCvHlUJhs9xNpe63PCXk3N9CRlvXW-vwoypSGSL-zQ00H3pi7lOs9kqlXCzEwrZ32et3TL74E_PKO4G5F3wt6NCnz9Xv__qM9v7sYeuyeDaRGv5T7b2Vxe-RcI2DbuZbDKP184PI0 priority: 102 providerName: ProQuest – databaseName: Springer Nature OA Free Journals dbid: C6C link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwlV1baxQxFA5aQXyReh-tEkHwQQcnk8ll-taullaoTxb6FpJsggtltrjbB_HPe06SnXbWC8gyL5uTmcmcS76TyxdC3kBW5XrrdA1o2tedcL52rde1Ek6FELybh7TK94s8Pus-n4vzQpODe2Fuzt8zLT-sIH6CLqFnqQHLtqxWt8kdAYEXrXkmZ-OMAR4yv9kU88d6k44n8fP_HoVvdEPbSyS35klT93O0S-4X3EgPsqIfkFtheEjunpaZ8UfkJ-ib5h2SP-gy0szZT_M2R4rruyjAU5oXjFMcfaVucYl5LZ0XAs4VXQwU8CA9WafBj617ZM7n_SQBOPjjySktwziPydnRp6-z47ocrFB72eh1zaOSc2d1HzVScHnAIE0Pjum1ndumjUwK50ASQl_ovEIKfK09xkaf8CR_QnaG5RCeEcq8iizaPjivIPfRFn5NYz3vrEcysIqwzVc3vrCO4-EXFyZlH1qarCkDmjJJU0ZV5N1Y5zJzbvxT-hCVOUoiX3b6A8zIFPczPedCqjZ03LmOtVGr4EWIrYSrj7KtyFs0BYNeDa_nbdmcAI1EfixzoATgIql5V5G9iSR4o58Wb4zJlGiwMpDWQmCFVBqe83osxpq4wm0Iy6skIzQSekGDnmbbG5vEFWdto2RF9MQqJ22elgyLb4krnGGODSi7Iu83Bnz9Xn__qM__T_wFudcmV0NOyz2ys_5-FV4CWFu7V8lLfwEBLjWK priority: 102 providerName: Springer Nature |
| Title | The quality of mental health care for people with bipolar disorders in the Italian mental health system: the QUADIM project |
| URI | https://link.springer.com/article/10.1186/s12888-023-04921-7 https://www.ncbi.nlm.nih.gov/pubmed/37312076 https://www.proquest.com/docview/2827038402 https://www.proquest.com/docview/2825809717 https://pubmed.ncbi.nlm.nih.gov/PMC10261835 https://doaj.org/article/9335672e43bb412f87ec5ef26ef29f62 |
| Volume | 23 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV1ta9swED76AmNfxt7nrg0aDPZh0-ZXSR6U0WQt7aBllAXCvghLkbdAcdokhZb--d3Jdjpn3RghgURnx5LuTs9Jp0cArzGqMnlhFEc0bXmaGctNbBWXmZHOOWvGzmf5nojDYfpllI3WoD3uqGnA-Z2hHZ0nNZydvb-6uP6EBr_rDV6JD3P0sdjfOPpwxLtxxOU6bPr1IkrlS29XFegger_bSEYch7VRu4nmznt0BirP5_-n1_5t2FpNqVxZV_XD1cFDeNDgTLZXK8YjWHPVY7h33KykP4Eb1A9W76i8ZtOS1Rz_rN4WySgfjCGcZXWCOaPZWmYm59RYbNwQds7ZpGKIH9nRwk-WrNyj5oj-6CUQN38-OmbNtM9TGB7sfxsc8uYgBm5FqBY8KaUYm0LlpSLKLouYJczRkK0qxkUYl5HIjEFJdJUutZIo85Wy5Eutx5_JM9ioppV7ASyysozKInfGSoyVVIGvMCxskhaWyMMCiNpW17ZhKafDMs60j1aU0HVPaewp7XtKywDeLq85rzk6_indp85cShK_tv9hOvuhG3PVeZJkQsYuTYxJo7hU0tnMlbHAd16KOIA3pAqa9BIfzxbNZgasJPFp6T2ZIY4SKkkD2O5IovXabnGrTLpVfo1hMDpiDL3xf14ti-lKyoir3PTSy2SKCMCwQs9r3VtWKZFJFIdSBKA6Wtmpc7ekmvz03OIRxeSIygN41yrw7XP9vVG3_rs9XsL92FsZ0V9uw8Zidul2ENctTA_W5Uj2YLO_f_L1FL8NxKDn50h63ozx87T__RdGKUtU |
| linkProvider | Scholars Portal |
| linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV3db9MwED-NTgJeEN8EBhgJxANES5wPO0gT2timlq0VQpu0NxM7DlRCaVk7oYn_jb-NO8fpaBF7m6q81Jcozp3vw777HcBLjKp0UWoZojdtwjTTJtTcyFBkWlhrja6sy_Id5f3j9ONJdrIGv7taGEqr7HSiU9TVxNAe-SaGBiicGI7w99MfIXWNotPVroVG6VsrVFsOYswXdhzY858Yws22BrvI71ec7-8dfeiHvstAaPJIzsOkFnmlS1nUkvCoDBrkqEApNbKsyojXcZ5pjZSoB2xqBOHBS2lIURjnXCX43GuwntIGSg_Wd_ZGnz4vzjEEOjRdqY7MN2doDVAy0U6G6JnzOBRL5tB1DfjXNvxlHFcTN1dOb51R3L8Nt7w3y7Zb8bsDa7a5C9eH_rz-HvxCKWRt3eY5m9Ss7STA2uJLRllnDJ1m1qaxM9oTZno8pWibVR4WdMbGDUMvlQ3mbktm5RktEvU7R4He-e5gyPzm0n04vhJGPIBeM2nsI2CxEXVcl4XVRmBEJkv8RVFpkrQ0BFEWQNx9dWU8Fjq15PiuXEwkc9VySiGnlOOUEgG8WdwzbZFALqXeIWYuKAnF2_0xOf2qvFJQRZJkueA2TbROY15LYU1ma57jVdQ5D-A1iYIiXYOvZ0pfMoGTJNQutS0y9NZymaQBbCxRoo4wy8OdMCmvo2bqYkUF8GIxTHdS3l1jJ2eOJpMEM4YTetjK3mJKiUhiHok8ALkklUtzXh5pxt8cgnlMkT_6_gG87QT44r3-_1EfXz6N53CjfzQ8VIeD0cETuMndMiOUzQ3ozU_P7FN0H-f6mV-jDL5ctVr4Ax13fp8 |
| linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwlV3db9MwELdgkyZeEONrgTGMhMQDRMun7fDWbVRrYRMSTNqbFTs2VEJptWYPiH-eO9sJS_mQUNWX-tLE8d35d_bdz4S8hKhKVbUSMaBpHRel0rHKtIh5qbgxRqvGuCzfc3Z6Ucwvy8sbVfwu273fkvQ1DcjS1HaHq8Z6ExfscA1eFUYY5psYEG6Wxvw22RZlVUH4tT2ZzD_Nh50EPHy-L5b545WjCcnx9v_unW9MT5upkxv7p25amt4jdwOepBOvALvklmnvk52zsGP-gPwAPaC-cvI7XVrqufypL3-kmPdFAbZSn0hOcVWWqsUK413aBGLONV20FHAinXVuUWTjPzwX9FsnAfj4ZHZGw_LOQ3Ixfff5-DQOBy7EmiWii3PLWaNqUVmB1FwasElSgcFqUTd1ktmUlUqBJLhEU2iO1PhCaPSZ2uHM_BHZapet2SM01dymtq6M0hxiIlHDJ0lqnRe1RpKwiKT9W5c6sJHjoRjfpItKBJN-pCSMlHQjJXlEXg_XrDwXxz-lj3AwB0nk0XY_LK--yGCWssrzkvHMFLlSRZpZwY0ujc0YfCvLsoi8QlWQaO3weLoORQvQSeTNkhNeAl5iIi8isj-SBCvV4-ZemWTwEmsJ4S44XAix4T4vhma8EjPfWrO8djKlQKIv6NBjr3tDl3Kep1nCWUTESCtHfR63tIuvjkM8xdgb0HdE3vQK_Ou5_v5Sn_yf-HOy8_FkKj_Mzt8_JXcyZ3VIe7lPtrqra_MM8FynDoLJ_gR5KEI3 |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+quality+of+mental+health+care+for+people+with+bipolar+disorders+in+the+Italian+mental+health+system%3A+the+QUADIM+project&rft.jtitle=BMC+psychiatry&rft.au=D%27Avanzo%2C+Barbara&rft.au=Barbato%2C+Angelo&rft.au=Monzio+Compagnoni%2C+Matteo&rft.au=Caggiu%2C+Giulia&rft.date=2023-06-13&rft.pub=BioMed+Central+Ltd&rft.issn=1471-244X&rft.eissn=1471-244X&rft.volume=23&rft.issue=1&rft_id=info:doi/10.1186%2Fs12888-023-04921-7&rft.externalDocID=A752936834 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1471-244X&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1471-244X&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1471-244X&client=summon |