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. 2009 May-Jun;28(3):701-12.
doi: 10.1377/hlthaff.28.3.701.

Improving quality and diffusing best practices: the case of schizophrenia

Marcela Horvitz-Lennon  1 , Julie M Donohue, Marisa E Domino, Sharon-Lise T Normand
Affiliations

Improving quality and diffusing best practices: the case of schizophrenia

Marcela Horvitz-Lennon et al. Health Aff (Millwood). 2009 May-Jun.

Abstract

The slow spread of treatments supported by empirical evidence and the rapid diffusion of treatments lacking such support play major roles in the lower quality of mental health care received by people with severe mental illnesses compared with the care of less severely ill people. Further, the rapid spread of treatments that are of low cost-effectiveness limits the system's ability to provide the full gamut of high-value treatments available to treat this vulnerable population. Using the case of schizophrenia, we review the context in which these paradoxical patterns of diffusion have occurred, and we propose policy solutions.

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Figures

Exhibit 1
Exhibit 1
Daily dose units (DDUs) of clozapine per thousands of Medicaid enrollees, by clozapine form, over time (1996 − 2005, selected quarters shown) Source: Authors’ calculations from 1996−2005, fee-for-service Medicaid claims data.
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References

    1. Although the diffusion literature tends to distinguish between active efforts to promote the adoption of innovations and their passive spread reserving the term diffusion to describe only the latter, our usage of the term diffusion encompasses both concepts.

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