The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4138.0: Tuesday, November 18, 2003 - Table 3

Abstract #53224

Assessing the Validity of General Assessment of Functioning as a Mental Health Outcome Performance Measure in the Veterans Health Administration

Greg Greenberg, Phd, Northeast Program Evaluation Center, VAMC West Haven, Ct. as well as Yale University Department of Psychiatry, New Haven, CT., VA Northeast Program Evaluation Center /182, 950 Campbell Ave, New haven, CT 06511, 203-789-0487, greenberg@biomed.med.yale.edu and Robert A. Rosenheck, MD, Northeast Administration Evaluation Center (NEPEC), Veterans Administration Medical Center, 950 Campbell Avenue, West Haven, CT 06516.

We evaluated the validity of the Global Assessment of Functioning (GAF) score and several measures derived from this score. Our sample consisted of 279,904 veterans who received outpatient care in 2000, 252,221 veterans who received such services in 2001, as well as 14,626 veterans in 2000 and 11,210 veterans in 2001who received inpatient services. These services were provided at more than 130 medical centers in 22 regions. For outpatients who had received services less than a year we measured the difference between a baseline and a GAF rating occurring between 45 and 135 days later, for longer term outpatients we measured the difference between a baseline GAF rating and a GAF rating occurring at least 6 months later, and for discharged inpatients we measured the difference between an inpatient GAF rating and an outpatient rating occurring between 45 and 135 days later. We then evaluated the degree to which veterans health status and socioeconomic characteristics were associated with expected differences these three GAF change measures (i.e., their discriminant validity). Next, we created risk- adjusted versions of the GAF change measures at both the medical center and regional levels, adjusting for patient sociodemographic characteristics and patient diagnosis. We then analyzed the internal validity of medical center and regional level performance scales that were created using the three risk-adjusted GAF change measures. Lastly, we examined the consistency of all organizational level measures over time. The findings we will present provide important validation for the GAF score as well as measures that we derived from it.

Learning Objectives:

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employer

Evaluation of Performance of Public Health Programs Roundtable

The 131st Annual Meeting (November 15-19, 2003) of APHA