TY - JOUR
KW - Integrated Health Care Systems
KW - Mental Health
KW - Primary Health Care
KW - Rural Health
AU - G. Burfeind
AU - D. Seymour
AU - S. H. Sillau
AU - L. Zittleman
AU - J. M. Westfall
A1 - 
AB - BACKGROUND: Integrated primary care, a health care delivery model that combines medical and behavioral health services, provides better patient access to care at a lower cost, with better outcomes compared with usual nonintegrated care models. The perspectives of primary care providers (PCPs) and behavioral health care providers (BHPs) toward integration are especially valuable because their input and endorsement are key to successful and sustained integration. However, there is little research assessing or comparing PCP and BHP perspectives on integration, especially in rural areas. The objective of this study was to identify rural PCP and BHP perspectives on integration. METHODS: Written and electronic surveys were distributed to PCPs and BHPs in the High Plains Research Network in rural eastern Colorado. Items included perspectives on improving behavioral health care, barriers to integration, and confidence in the ability to integrate primary and behavioral care. RESULTS: Surveys were completed by 88 PCPs (60%), and 49 BHPs (63%), for an overall response rate of 61%. PCPs were significantly more likely than BHPs to prefer improving referral methods (odds ratio [OR], 2.2; P = .03) and significantly less likely to prefer colocation (OR, 0.2; P < .0001), warm hand-offs (OR, 0.3; P < .01), improved behavioral health training for PCPs (OR, 0.4; P < .01), and shared visits (OR, 0.4; P =.03) as ways to improve health care. Lack of sufficient methods of payment for behavioral health care services was the most commonly selected barrier to integration by both groups. PCPs were significantly more likely than BHPs to select recruitment (OR, 3.8; P < .001) and retention (OR, 2.7; P < .01) of behavioral health care staff as a major barrier. BHPs were slightly more optimistic than PCPs about the achievability of integration. CONCLUSIONS: Important differences of perspective exist between rural PCPs and BHPs regarding the best ways to improve behavioral health care, barriers to integration, and the achievability of integration. These differences may have important implications for rural communities and health care systems considering a transition to an integrated primary care model.
BT - Journal of the American Board of Family Medicine : JABFM
C5 - Education & Workforce
CP - 3
CY - United States
DO - 10.3122/jabfm.2014.03.130152
IS - 3
JF - Journal of the American Board of Family Medicine : JABFM
N2 - BACKGROUND: Integrated primary care, a health care delivery model that combines medical and behavioral health services, provides better patient access to care at a lower cost, with better outcomes compared with usual nonintegrated care models. The perspectives of primary care providers (PCPs) and behavioral health care providers (BHPs) toward integration are especially valuable because their input and endorsement are key to successful and sustained integration. However, there is little research assessing or comparing PCP and BHP perspectives on integration, especially in rural areas. The objective of this study was to identify rural PCP and BHP perspectives on integration. METHODS: Written and electronic surveys were distributed to PCPs and BHPs in the High Plains Research Network in rural eastern Colorado. Items included perspectives on improving behavioral health care, barriers to integration, and confidence in the ability to integrate primary and behavioral care. RESULTS: Surveys were completed by 88 PCPs (60%), and 49 BHPs (63%), for an overall response rate of 61%. PCPs were significantly more likely than BHPs to prefer improving referral methods (odds ratio [OR], 2.2; P = .03) and significantly less likely to prefer colocation (OR, 0.2; P < .0001), warm hand-offs (OR, 0.3; P < .01), improved behavioral health training for PCPs (OR, 0.4; P < .01), and shared visits (OR, 0.4; P =.03) as ways to improve health care. Lack of sufficient methods of payment for behavioral health care services was the most commonly selected barrier to integration by both groups. PCPs were significantly more likely than BHPs to select recruitment (OR, 3.8; P < .001) and retention (OR, 2.7; P < .01) of behavioral health care staff as a major barrier. BHPs were slightly more optimistic than PCPs about the achievability of integration. CONCLUSIONS: Important differences of perspective exist between rural PCPs and BHPs regarding the best ways to improve behavioral health care, barriers to integration, and the achievability of integration. These differences may have important implications for rural communities and health care systems considering a transition to an integrated primary care model.
PP - United States
PY - 2014
SN - 1557-2625; 1557-2625
SP - 375
EP - 382
EP - 
T1 - Provider perspectives on integrating primary and behavioral health: a report from the high plains research network
T2 - Journal of the American Board of Family Medicine : JABFM
TI - Provider perspectives on integrating primary and behavioral health: a report from the high plains research network
U1 - Education & Workforce
U2 - 24808116
U3 - 10.3122/jabfm.2014.03.130152
VL - 27
VO - 1557-2625; 1557-2625
Y1 - 2014
ER -