TY - JOUR
KW - Adult
KW - Community Health Services
KW - Community Mental Health Centers
KW - Delivery of Health Care, Integrated
KW - Female
KW - Humans
KW - Male
KW - Mental Disorders/therapy
KW - Mental Health Services
KW - Patient Satisfaction
KW - Primary Health Care
KW - Qualitative Research
AU - M. M. Davis
AU - R. Gunn
AU - L. K. Gowen
AU - B. F. Miller
AU - L. A. Green
AU - D. J. Cohen
A1 - 
AB - Integrated behavioral health and primary care is a patient-centered approach designed to address a person's physical, emotional, and social healthcare needs. Increasingly, practices are integrating care to help achieve the Quadruple Aim, yet no studies have examined, using qualitative methods, patients' experiences of care in integrated settings. The purpose of this study was to examine patients' experiences of care in community-based settings integrating behavioral health and primary care. This is a qualitative study of 24 patients receiving care across five practices participating in Advancing Care Together (ACT). ACT was a 4-year demonstration project (2010-2014) of primary care and community mental health centers (CMHCs) integrating care. We conducted in-depth interviews in 2014 and a multidisciplinary team analyzed data using an inductive qualitative descriptive approach. Nineteen patients described receiving integrated care. Both primary care and CMHC patients felt cared for when the full spectrum of their needs, including physical, emotional, and social circumstances, were addressed. Patients perceived personal, interpersonal, and organizational benefits from integrated care. Interactions with integrated team members helped patients develop and/or improve coping skills; patients shared lessons learned with family and friends. Service proximity, provider continuity and trust, and a number of free initial behavioral health appointments supported patient access to, and engagement with, integrated care. In contrast, patients' prior experience, provider "mismatch," clinician turnover, and restrictive insurance coverage presented barriers in accessing and sustaining care. Patients in both primary care and CMHCs perceived similar benefits from integrated care related to personal growth, improved quality, and access to care. Policy makers and practice leadership should attend to proximity, continuity, trust, and cost/coverage as factors that can impede or facilitate engagement with integrated care.
AD - Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.; Oregon Rural Practice-based Research Network, Portland, OR, USA.; Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.; Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.; Eugene S. Farley, Jr. Health Policy Center, Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.; Eugene S. Farley, Jr. Health Policy Center, Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.; Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA.
BT - Translational behavioral medicine
C5 - General Literature
CP - 5
CY - England
DO - 10.1093/tbm/ibx001
IS - 5
JF - Translational behavioral medicine
M1 - Journal Article
N2 - Integrated behavioral health and primary care is a patient-centered approach designed to address a person's physical, emotional, and social healthcare needs. Increasingly, practices are integrating care to help achieve the Quadruple Aim, yet no studies have examined, using qualitative methods, patients' experiences of care in integrated settings. The purpose of this study was to examine patients' experiences of care in community-based settings integrating behavioral health and primary care. This is a qualitative study of 24 patients receiving care across five practices participating in Advancing Care Together (ACT). ACT was a 4-year demonstration project (2010-2014) of primary care and community mental health centers (CMHCs) integrating care. We conducted in-depth interviews in 2014 and a multidisciplinary team analyzed data using an inductive qualitative descriptive approach. Nineteen patients described receiving integrated care. Both primary care and CMHC patients felt cared for when the full spectrum of their needs, including physical, emotional, and social circumstances, were addressed. Patients perceived personal, interpersonal, and organizational benefits from integrated care. Interactions with integrated team members helped patients develop and/or improve coping skills; patients shared lessons learned with family and friends. Service proximity, provider continuity and trust, and a number of free initial behavioral health appointments supported patient access to, and engagement with, integrated care. In contrast, patients' prior experience, provider "mismatch," clinician turnover, and restrictive insurance coverage presented barriers in accessing and sustaining care. Patients in both primary care and CMHCs perceived similar benefits from integrated care related to personal growth, improved quality, and access to care. Policy makers and practice leadership should attend to proximity, continuity, trust, and cost/coverage as factors that can impede or facilitate engagement with integrated care.
PP - England
PY - 2018
SN - 1613-9860; 1613-9860
SP - 649
EP - 659
EP - 
T1 - A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different
T2 - Translational behavioral medicine
TI - A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different
U1 - General Literature
U2 - 29425354
U3 - 10.1093/tbm/ibx001
VL - 8
VO - 1613-9860; 1613-9860
Y1 - 2018
Y2 - Sep 8
ER -