Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana - structural equation modelling.

Journal: PloS one

Volume: 15

Issue: 5

Year of Publication: 2020

Affiliated Institutions:  School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Newcastle, Australia. School Nursing and Midwifery, Faculty Health and Medicine, University of Newcastle, Newcastle, Australia. Macquarie Business School, Macquarie University, Sydney, Australia. Ghana Health Services, Accra, Ghana.

Abstract summary 

Incorporating consumers' perspectives into the quality of mental health service measurement is a growing priority among mental health professionals' and policymakers. Despite this, there is limited empirical evidence related to consumer perspectives of quality of mental health services. This study, therefore, aims to measure the mediation and moderation effects of health system structure and process on mental health quality in Ghana.A random sample of 510 consumers were recruited to complete the Verona Satisfaction Scale (54-items), together with the WHO Disability Assessment Instrument (36 items) using the Redcap application. Confirmatory factor analysis (CFA) and Structural Equation Modelling were used to test the hypothesised theory using STATA 15.The CFA showed that the hypothesised model had a good fit to the data. The findings confirmed the hypothesis that the process constructs mediate the relationship between the health system structure and the outcome of mental health services. Specifically, the health system structure had a positive and significant causal relationship with the mediator-process (β = 0.60; p<0.01) and outcome (β = 0.47; p<0.01). Additionally, the mediator-process had a positive causal relationship with the outcome of the mental health services (β = 0.32; p<0.01). Insurance status (β = 0.07; p>0.05) and type of services (β = 0.025; p>0.05) had a positive moderating effect on the relationship between health system structure and outcome but were not significant.Improvements to mental health system structure and the process could promote the quality of services as experienced by consumers. Government stakeholders are encouraged to accordingly strengthen health systems with the aim of improving the mental health outcomes for consumers.

Authors & Co-authors:  Badu Eric E O'Brien Anthony Paul AP Mitchell Rebecca R Osei Akwasi A

Study Outcome 

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Statistics
Citations :  Funk M, Lund C, Freeman M, Drew N. Improving the quality of mental health care. International Journal for Quality in Health Care. 2009;21(6):415–20. 10.1093/intqhc/mzp048
Authors :  4
Identifiers
Doi : e0233351
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Ghana
Publication Country
United States