TY - JOUR
AU - A. S. Young
AU - J. Skela
AU - E. T. Chang
AU - R. Oberman
AU - P. Siddarth
A1 - 
AB - PURPOSE: The population with serious mental illness has high risk for hospitalization or death due to unhealthy behaviors and inadequate medical care, though the level of risk varies substantially. Programs that integrate medical and psychiatric services improve outcomes but are challenging to implement and access is limited. It would be useful to know whether benefits are confined to patients with specific levels of risk. METHODS: In a population with serious mental illness and increased risk for hospitalization or death, a specialized medical home integrated services and improved treatment and outcomes. Treatment quality, chronic illness care, care experience, symptoms, and quality of life were assessed for a median of 385 days. Analyses examine whether improvements varied by baseline level of patient risk. RESULTS: Patients with greater risk were more likely to be older, more cognitively impaired, and have worse mental health. Integrated services increased appropriate screening for body mass index, lipids, and glucose, but increases did not differ significantly by level of risk. Integrated services also improved chronic illness care, care experience, mental health-related quality of life, and psychotic symptoms. There were also no significant differences by risk level. CONCLUSIONS: There were benefits from integration of primary care and psychiatric care at all levels of increased risk, including those with extremely high risk above the 95th percentile. When developing integrated care programs, patients should be considered at all levels of risk, not only those who are the healthiest.
AD - Desert Pacific Mental Illness Research Education and Clinical Center, Greater Los Angeles Veterans Healthcare System, Los Angeles, California, United States of America.; Department of Psychiatry, School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America.; HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles Veterans Healthcare System, Los Angeles, California, United States of America.; Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America.; Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America.
AN - 38781176
BT - PLoS One
C5 - Medical Home
CP - 5
DO - 10.1371/journal.pone.0304312
DP - NLM
ET - 20240523
IS - 5
JF - PLoS One
LA - eng
N2 - PURPOSE: The population with serious mental illness has high risk for hospitalization or death due to unhealthy behaviors and inadequate medical care, though the level of risk varies substantially. Programs that integrate medical and psychiatric services improve outcomes but are challenging to implement and access is limited. It would be useful to know whether benefits are confined to patients with specific levels of risk. METHODS: In a population with serious mental illness and increased risk for hospitalization or death, a specialized medical home integrated services and improved treatment and outcomes. Treatment quality, chronic illness care, care experience, symptoms, and quality of life were assessed for a median of 385 days. Analyses examine whether improvements varied by baseline level of patient risk. RESULTS: Patients with greater risk were more likely to be older, more cognitively impaired, and have worse mental health. Integrated services increased appropriate screening for body mass index, lipids, and glucose, but increases did not differ significantly by level of risk. Integrated services also improved chronic illness care, care experience, mental health-related quality of life, and psychotic symptoms. There were also no significant differences by risk level. CONCLUSIONS: There were benefits from integration of primary care and psychiatric care at all levels of increased risk, including those with extremely high risk above the 95th percentile. When developing integrated care programs, patients should be considered at all levels of risk, not only those who are the healthiest.
PY - 2024
SN - 1932-6203
SP - e0304312
ST - Variation in benefit among patients with serious mental illness who receive integrated psychiatric and primary care
T1 - Variation in benefit among patients with serious mental illness who receive integrated psychiatric and primary care
T2 - PLoS One
TI - Variation in benefit among patients with serious mental illness who receive integrated psychiatric and primary care
U1 - Medical Home
U3 - 10.1371/journal.pone.0304312
VL - 19
VO - 1932-6203
Y1 - 2024
ER -