Medical audit has been defined as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patients (Department of Health, 1989). The medical profession has been under pressure to extend and improve audit procedures in recent years (McKee et al, 1989), but there have been doubts about the most satisfactory methods, particularly in psychiatry (Garden & Oyebode, 1989). There are numerous methodological problems in measuring the outcome of psychosocial care (Shaw, 1989; Royal College of Psychiatrists, 1989). Indicators of outcome which have been used in medicine include incidence of adverse events. Reintervention rates do offer some measure of outcome, and have been used widely in other medical specialities.
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