TY - JOUR
KW - behavioral health integration
KW - patient experience
KW - provider relationships
KW - Stigma
AU - Royal Kenton
AU - L. Broffman
AU - K. Jones
AU - Albrecht Mcmenamin
AU - M. Weller
AU - K. Brown
AU - J. Currier
AU - B. Wright
A1 - 
AB - Behavioral health integration (BHI) models seek to improve patient experience and outcomes by bridging physical and behavioral health services. Past BHI research has not focused on stigma in these settings, which has been previously found to impact patient engagement and outcomes. We surveyed patients over a two year period at 12 integrated clinics in Oregon using measures developed by a Patient Advisory Team. Over a quarter of respondents reported stigmatization (26.81%). Compared to non-stigmatized patients, those who reported stigma had five times the odds of reporting unmet health needs (OR=5.14, p<0.0001), three times the odds reporting issues accessing care (OR=2.93, p<0.0001), six times the odds reporting hassle to get care (OR=6.49, p<0.0001), and three times the odds of reporting poor communication between providers (OR=3.45, p<0.0001). After examining the interaction between stigmatization and time, we found that stigmatized patients had lower odds at year two of reporting unmet health needs (OR=0.68, p=0.0034), issues accessing care (OR=0.77, p=0.0400), hassle getting care (OR=0.57, p=0.0001), and poor provider communication (OR=0.77, p=0.0544). We found that stigma remained prevalent for patients seeking care in the integrated clinics studied despite integration. Systems should consider integration efforts and reducing stigmatizing experiences in tandem to truly improve patient outcomes.
BT - Psychology, Health & Medicine
C5 - General Literature
CY - England
DO - 10.1080/13548506.2019.1595685
JF - Psychology, Health & Medicine
N2 - Behavioral health integration (BHI) models seek to improve patient experience and outcomes by bridging physical and behavioral health services. Past BHI research has not focused on stigma in these settings, which has been previously found to impact patient engagement and outcomes. We surveyed patients over a two year period at 12 integrated clinics in Oregon using measures developed by a Patient Advisory Team. Over a quarter of respondents reported stigmatization (26.81%). Compared to non-stigmatized patients, those who reported stigma had five times the odds of reporting unmet health needs (OR=5.14, p<0.0001), three times the odds reporting issues accessing care (OR=2.93, p<0.0001), six times the odds reporting hassle to get care (OR=6.49, p<0.0001), and three times the odds of reporting poor communication between providers (OR=3.45, p<0.0001). After examining the interaction between stigmatization and time, we found that stigmatized patients had lower odds at year two of reporting unmet health needs (OR=0.68, p=0.0034), issues accessing care (OR=0.77, p=0.0400), hassle getting care (OR=0.57, p=0.0001), and poor provider communication (OR=0.77, p=0.0544). We found that stigma remained prevalent for patients seeking care in the integrated clinics studied despite integration. Systems should consider integration efforts and reducing stigmatizing experiences in tandem to truly improve patient outcomes.
PP - England
PY - 2019
SN - 1465-3966; 1354-8506
SP - 1
EP - 16
EP - 
T1 - Patient experiences in behavioral health integrated primary care settings: the role of stigma in shaping patient outcomes over time
T2 - Psychology, Health & Medicine
TI - Patient experiences in behavioral health integrated primary care settings: the role of stigma in shaping patient outcomes over time
U1 - General Literature
U2 - 30924365
U3 - 10.1080/13548506.2019.1595685
VO - 1465-3966; 1354-8506
Y1 - 2019
ER -