The journal of mental health administration

, Volume 22, Issue 1, pp 68–76 | Cite as

Regional variation in service system performance: Comparing the perceptions of key stakeholders

  • William H. Fisher
  • Barbara Dickey
Regular Articles

Abstract

Area variation studies rarely focus on perceptions of service system performance in their comparative analyses. Using an instrument designed specifically for assessing key stakeholders’ perceptions of the performance of mental health service delivery systems, this study compared three areas in Massachusetts that differ significantly with regard to service system structure and resource allocation. Despite these differences, key stakeholders’ perceptions of service system adequancy, availability, quality, and coordination did not vary substantially, although the findings suggest that to some extent organizational structure may have more effect than resource availability and allocation on perceptions of key stakeholders within the three systems. These differences were also of far less magnitude than differences in hospitalization rates and other more traditional measures of service system performance. The authors argue that stakeholders’ perceptions should be considered, along with other standard performance measures, in evaluating service system performance.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Wennberg JE, Gittleson A: Variations in medical care among small areas.Scientific American 1982;246: 120–133.PubMedCrossRefGoogle Scholar
  2. 2.
    Fisher WH, Geller JL, Altaffer F, et al.: The relationship between community resources and state hospital recidivism.American Journal of Psychiatry 1992; 149:385–390.PubMedGoogle Scholar
  3. 3.
    Fisher WH, McDermeit M, Geller JL, et al.: Variations in Patterns of Service Use by the Severely Mentally Ill: The Role of Functional Level and Service System Characteristics. Paper presented at the annual meeting of the American Public Health Association, San Francisco, October 25, 1993.Google Scholar
  4. 4.
    Morrissey JP, Ridgely S, Goldman H, et al.: Assessments of community mental health support systems: A key informant approach.Community Mental Health Journal. In press.Google Scholar
  5. 5.
    Morrissey JP, Calloway M, Bartko WT, et al.: Local mental health authorities and service system change: Evidence from the Robert Wood Johnson Foundation Program on Chronic Mental Illness.Milbank Quarterly 1994; 72:49–90.PubMedCrossRefGoogle Scholar
  6. 6.
    Northampton Consent Decree, Civil Action 76-4423-F (D-Mass, ordered December 7, 1978).Google Scholar
  7. 7.
    Geller JL, Fisher WH, Wirth Cauchon JL, et al.: Second generation deinstitutionalization, I: The impact ofBrewster v Dukakis on state hospital case mix.American Journal of Psychiatry 1991; 147:982–986.Google Scholar
  8. 8.
    Goldman H, Lehman A, Morrissey J, et al.: Design for the national evaluation of the Robert Wood Johnson Foundation Program on Chronic Mental Illness.Hospital and Community Psychiatry 1990; 41:1217–1230.PubMedGoogle Scholar
  9. 9.
    Blalock HM:Social Statistics. New York: McGraw Hill, 1972.Google Scholar

Copyright information

© Association of Mental Health Administrators 1995

Authors and Affiliations

  • William H. Fisher
    • 1
  • Barbara Dickey
    • 2
  1. 1.Department of PsychiatryUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Harvard Medical SchoolUSA

Personalised recommendations