Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery

Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Mary Anne Furst [verfasserIn] Coralie Gandré [verfasserIn] Cristina Romero López-Alberca [verfasserIn] Luis Salvador-Carulla [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	Mental health care systems Mental health care comparison Mental health care delivery Mental health systems research

Übergeordnetes Werk:	In: BMC Health Services Research - BMC, 2003, 19(2019), 1, Seite 13
Übergeordnetes Werk:	volume:19 ; year:2019 ; number:1 ; pages:13

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s12913-019-4005-5

Katalog-ID:	DOAJ046603514

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allfields	10.1186/s12913-019-4005-5 doi (DE-627)DOAJ046603514 (DE-599)DOAJa2d3ad154d534a739cf7cb3b48c220c6 DE-627 ger DE-627 rakwb eng RA1-1270 Mary Anne Furst verfasserin aut Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems. Mental health care systems Mental health care comparison Mental health care delivery Mental health systems research Public aspects of medicine Coralie Gandré verfasserin aut Cristina Romero López-Alberca verfasserin aut Luis Salvador-Carulla verfasserin aut In BMC Health Services Research BMC, 2003 19(2019), 1, Seite 13 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:19 year:2019 number:1 pages:13 https://doi.org/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/article/a2d3ad154d534a739cf7cb3b48c220c6 kostenfrei http://link.springer.com/article/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2019 1 13
spelling	10.1186/s12913-019-4005-5 doi (DE-627)DOAJ046603514 (DE-599)DOAJa2d3ad154d534a739cf7cb3b48c220c6 DE-627 ger DE-627 rakwb eng RA1-1270 Mary Anne Furst verfasserin aut Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems. Mental health care systems Mental health care comparison Mental health care delivery Mental health systems research Public aspects of medicine Coralie Gandré verfasserin aut Cristina Romero López-Alberca verfasserin aut Luis Salvador-Carulla verfasserin aut In BMC Health Services Research BMC, 2003 19(2019), 1, Seite 13 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:19 year:2019 number:1 pages:13 https://doi.org/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/article/a2d3ad154d534a739cf7cb3b48c220c6 kostenfrei http://link.springer.com/article/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2019 1 13
allfields_unstemmed	10.1186/s12913-019-4005-5 doi (DE-627)DOAJ046603514 (DE-599)DOAJa2d3ad154d534a739cf7cb3b48c220c6 DE-627 ger DE-627 rakwb eng RA1-1270 Mary Anne Furst verfasserin aut Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems. Mental health care systems Mental health care comparison Mental health care delivery Mental health systems research Public aspects of medicine Coralie Gandré verfasserin aut Cristina Romero López-Alberca verfasserin aut Luis Salvador-Carulla verfasserin aut In BMC Health Services Research BMC, 2003 19(2019), 1, Seite 13 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:19 year:2019 number:1 pages:13 https://doi.org/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/article/a2d3ad154d534a739cf7cb3b48c220c6 kostenfrei http://link.springer.com/article/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2019 1 13
allfieldsGer	10.1186/s12913-019-4005-5 doi (DE-627)DOAJ046603514 (DE-599)DOAJa2d3ad154d534a739cf7cb3b48c220c6 DE-627 ger DE-627 rakwb eng RA1-1270 Mary Anne Furst verfasserin aut Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems. Mental health care systems Mental health care comparison Mental health care delivery Mental health systems research Public aspects of medicine Coralie Gandré verfasserin aut Cristina Romero López-Alberca verfasserin aut Luis Salvador-Carulla verfasserin aut In BMC Health Services Research BMC, 2003 19(2019), 1, Seite 13 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:19 year:2019 number:1 pages:13 https://doi.org/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/article/a2d3ad154d534a739cf7cb3b48c220c6 kostenfrei http://link.springer.com/article/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2019 1 13
allfieldsSound	10.1186/s12913-019-4005-5 doi (DE-627)DOAJ046603514 (DE-599)DOAJa2d3ad154d534a739cf7cb3b48c220c6 DE-627 ger DE-627 rakwb eng RA1-1270 Mary Anne Furst verfasserin aut Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems. Mental health care systems Mental health care comparison Mental health care delivery Mental health systems research Public aspects of medicine Coralie Gandré verfasserin aut Cristina Romero López-Alberca verfasserin aut Luis Salvador-Carulla verfasserin aut In BMC Health Services Research BMC, 2003 19(2019), 1, Seite 13 (DE-627)331018756 (DE-600)2050434-2 14726963 nnns volume:19 year:2019 number:1 pages:13 https://doi.org/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/article/a2d3ad154d534a739cf7cb3b48c220c6 kostenfrei http://link.springer.com/article/10.1186/s12913-019-4005-5 kostenfrei https://doaj.org/toc/1472-6963 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2019 1 13
language	English
source	In BMC Health Services Research 19(2019), 1, Seite 13 volume:19 year:2019 number:1 pages:13
sourceStr	In BMC Health Services Research 19(2019), 1, Seite 13 volume:19 year:2019 number:1 pages:13
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Mental health care systems Mental health care comparison Mental health care delivery Mental health systems research Public aspects of medicine
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container_title	BMC Health Services Research
authorswithroles_txt_mv	Mary Anne Furst @@aut@@ Coralie Gandré @@aut@@ Cristina Romero López-Alberca @@aut@@ Luis Salvador-Carulla @@aut@@
publishDateDaySort_date	2019-01-01T00:00:00Z
hierarchy_top_id	331018756
id	DOAJ046603514
language_de	englisch
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In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. 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author	Mary Anne Furst
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topic_title	RA1-1270 Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery Mental health care systems Mental health care comparison Mental health care delivery Mental health systems research
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title	Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery
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title_full	Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery
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title_sort	healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery
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title_auth	Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery
abstract	Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems.
abstractGer	Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems.
abstract_unstemmed	Abstract Background Evidence from the context of local health ecosystems is highly relevant for research and policymaking to understand geographical variations in outcomes of health care delivery. In mental health systems, the analysis of context presents particular challenges related to their complexity and to methodological difficulties. Method guidelines and standard recommendations for conducting context analysis of local mental health care are urgently needed. This scoping study reviews current methods of context analysis in mental health systems to establish the parameters of research activity examining availability and capacity of care at the local level, and to identify any gaps in the literature. Methods A scoping review based on a systematic search of key databases was conducted for the period 2005–2016. A systems dynamics/complexity approach was adopted, using a modified version of Tansella and Thornicroft’s matrix model of mental health care as the conceptual framework for our analysis. Results The lack of a specific terminology in the area meant that from 10,911 titles identified at the initial search, only 46 papers met inclusion criteria. Of these, 21 had serious methodological limitations. Fifteen papers did not use any kind of formal framework, and five of those did not describe their method. Units of analysis varied widely and across different levels of the system. Six instruments to describe service availability and capacity were identified, of which three had been psychometrically validated. A limitation was the exclusion of grey literature from the review. However, the imprecise nature of the terminology, and high number of initial results, makes the inclusion of grey literature not feasible. Conclusion We identified that, in spite of its relevance, context studies in mental health services is a very limited research area. Few validated instruments are available. Methodological limitations in many papers mean that the particular challenges of mental health systems research such as system complexity, data availability and terminological variability are generally poorly addressed, presenting a barrier to valid system comparison. The modified Thornicroft and Tansella matrix and related ecological production of care model provide the main model for research within the area of health care ecosystems.
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title_short	Healthcare ecosystems research in mental health: a scoping review of methods to describe the context of local care delivery
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