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The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
598 Results
161
Development and Validation of the Modified Patient-Centered Medical Home Assessment for the Comprehensive Primary Care Initiative
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Measures
See topic collection
, Medical Home
See topic collection
165
Do Medical Homes Improve Quality of Care for Persons with Multiple Chronic Conditions?
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Medical Home
See topic collection
Reference Links: 
View the DOI record for Do Medical Homes Improve Quality of Care for Persons with Multiple Chronic Conditions?
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View the PubMed citation for Do Medical Homes Improve Quality of Care for Persons with Multiple Chronic Conditions?166
Do medical homes increase medication adherence for persons with multiple chronic conditions?
Type: Journal Article
Year: 2015
Publication Place: United States
Abstract: BACKGROUND: Medications are an integral component of management for many chronic conditions, and suboptimal adherence limits medication effectiveness among persons with multiple chronic conditions (MCC). Medical homes may provide a mechanism for increasing adherence among persons with MCC, thereby enhancing management of chronic conditions. OBJECTIVE: To examine the association between medical home enrollment and adherence to newly initiated medications among Medicaid enrollees with MCC. RESEARCH DESIGN: Retrospective cohort study comparing Community Care of North Carolina medical home enrollees to nonenrollees using merged North Carolina Medicaid claims data (fiscal years 2008-2010). SUBJECTS: Among North Carolina Medicaid-enrolled adults with MCC, we created separate longitudinal cohorts of new users of antidepressants (N=9303), antihypertensive agents (N=12,595), oral diabetic agents (N=6409), and statins (N=9263). MEASURES: Outcomes were the proportion of days covered (PDC) on treatment medication each month for 12 months and a dichotomous measure of adherence (PDC>0.80). Our primary analysis utilized person-level fixed effects models. Sensitivity analyses included propensity score and person-level random-effect models. RESULTS: Compared with nonenrollees, medical home enrollees exhibited higher PDC by 4.7, 6.0, 4.8, and 5.1 percentage points for depression, hypertension, diabetes, and hyperlipidemia, respectively (P's<0.001). The dichotomous adherence measure showed similar increases, with absolute differences of 4.1, 4.5, 3.5, and 4.6 percentage points, respectively (P's<0.001). CONCLUSIONS: Among Medicaid enrollees with MCC, adherence to new medications is greater for those enrolled in medical homes.
Topic(s):
Medical Home
See topic collection
Reference Links:
View the DOI record for Do medical homes increase medication adherence for persons with multiple chronic conditions?
View DOI Record
View the PubMed citation for Do medical homes increase medication adherence for persons with multiple chronic conditions?167
Do Patient-Centered Medical Home Access and Care Coordination Measures Reflect the Contribution of All Team Members? A Systematic Review
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: Patient-Centered Medical Home (PCMH) evaluations have primarily focused on primary care providers and not on the primary care team. This systematic literature review examined the extent to which access and care coordination measures in PCMH reflect the involvement of associate care providers (ACPs), which include registered and licensed practical nurses, nursing and medical assistants, clerks, pharmacists, social workers, and dietitians. Among 42 studies, few measures specified ACP roles or linked ACP care to outcomes. Increasing attention on team-based care emphasizes a vital need to reframe measures within a team context.
Topic(s):
Education & Workforce
See topic collection
, Medical Home
See topic collection
168
Do Patient-Centered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of Low-Income Patients? A Systematic Review and Meta-Analysis
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Healthcare Disparities
See topic collection
, Medical Home
See topic collection
169
Do physicians address other medical problems during preventive gynecologic visits?
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: BACKGROUND: The patient-centered medical home model may be a strategic approach to improve delivery of women's health care and consistently provide women with accessible and comprehensive care. We examined whether primary care physicians (family medicine, internal medicine, and hospital general medicine clinics) and obstetrician-gynecologists differ in scope and the number of medical issues addressed during preventive gynecologic visits. METHODS: We analyzed data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to characterize visits with a primary diagnosis of gynecological examination or routine cervical Papanicolaou test between 1999 and 2008. We compared the number and type of concurrent nongynecologic diagnoses addressed by primary care physicians and obstetrician-gynecologists during visits. RESULTS: A total of 7882 visits were included, representing 271 million primary visits for Papanicolaou tests. Primary care physicians were 2.41 times more likely to include one or more concurrent medical diagnoses during the preventive gynecologic visit compared with obstetrician-gynecologists (odds ratio, 2.41; 95% confidence interval, 1.63-3.57). CONCLUSIONS: Primary care physicians are significantly more likely to address concurrent medical problems during preventive gynecologic visits compared with obstetrician-gynecologists. These findings demonstrate the vital role of primary care physicians in providing comprehensive health care to women, consistent with principles of the patient-centered medical home model.
Topic(s):
Healthcare Disparities
See topic collection
, Medical Home
See topic collection
, Education & Workforce
See topic collection
Reference Links:
View the DOI record for Do physicians address other medical problems during preventive gynecologic visits?
View DOI Record
View the PubMed citation for Do physicians address other medical problems during preventive gynecologic visits?170
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
Type: Journal Article
Year: 2016
Publication Place: United States
Topic(s):
Medical Home
See topic collection
, Healthcare Disparities
See topic collection
173
Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: BACKGROUND: Few studies have looked under the hood of practice redesign to understand whether and, if so, how staffing changed with the adoption of patient-centered medical home (PCMH), and whether these staffing changes impacted utilization. OBJECTIVES: To examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits. RESEARCH DESIGN, SUBJECTS, MEASURES: Using a difference-in-differences approach, we compared staffing and utilization outcomes in 450 community health centers that had adopted a PCMH model between 2007 and 2013 to a matched sample of 243 nonadopters located in the 50 states and the District of Columbia. RESULTS: We found that adopting a PCMH model was significantly associated with a growth in use of advanced practice staff (nurse practitioners and physician assistants) [0.53 full-time equivalent (FTE), 8.77%; P<0.001], other medical staff (medical assistants, nurse aides, and quality assurance staff) (1.23 FTE, 7.46%; P=0.001), mental health/substance abuse staff (0.73 FTE, 17.63%; P=0.005), and enabling service staff (case managers and health educators) (0.36 FTE, 6.14%; P=0.079), but not primary care physicians or nurses. We did not observe a significant increase in utilization, as measured in total number of visits per year. However, the visits marginally attributed to advanced practice staff (539 FTE, 0.89%; P=0.037) and mental health/substance abuse staff (353 FTE, 0.59%; P=0.051) significantly increased. CONCLUSIONS: Our findings suggest that the implementation of PCMH actively reengineers staff composition and this, in turn, results in changes in marginal utilization by each staff type.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
View DOI Record
View the PubMed citation for Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?174
Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: BACKGROUND: Few studies have looked under the hood of practice redesign to understand whether and, if so, how staffing changed with the adoption of patient-centered medical home (PCMH), and whether these staffing changes impacted utilization. OBJECTIVES: To examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits. RESEARCH DESIGN, SUBJECTS, MEASURES: Using a difference-in-differences approach, we compared staffing and utilization outcomes in 450 community health centers that had adopted a PCMH model between 2007 and 2013 to a matched sample of 243 nonadopters located in the 50 states and the District of Columbia. RESULTS: We found that adopting a PCMH model was significantly associated with a growth in use of advanced practice staff (nurse practitioners and physician assistants) [0.53 full-time equivalent (FTE), 8.77%; P<0.001], other medical staff (medical assistants, nurse aides, and quality assurance staff) (1.23 FTE, 7.46%; P=0.001), mental health/substance abuse staff (0.73 FTE, 17.63%; P=0.005), and enabling service staff (case managers and health educators) (0.36 FTE, 6.14%; P=0.079), but not primary care physicians or nurses. We did not observe a significant increase in utilization, as measured in total number of visits per year. However, the visits marginally attributed to advanced practice staff (539 FTE, 0.89%; P=0.037) and mental health/substance abuse staff (353 FTE, 0.59%; P=0.051) significantly increased. CONCLUSIONS: Our findings suggest that the implementation of PCMH actively reengineers staff composition and this, in turn, results in changes in marginal utilization by each staff type.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
View DOI Record
View the PubMed citation for Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?176
Early Impact Of CareFirst's Patient-Centered Medical Home With Strong Financial Incentives
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: In 2011 CareFirst BlueCross BlueShield, a large mid-Atlantic health insurance plan, implemented a payment and delivery system reform program. The model, called the Total Care and Cost Improvement Program, includes enhanced payments for primary care, significant financial incentives for primary care physicians to control spending, and care coordination tools to support progress toward the goal of higher-quality and lower-cost patient care. We conducted a mixed-methods evaluation of the initiative's first three years. Our quantitative analyses used spending and utilization data for 2010-13 to compare enrollees who received care from participating physician groups to similar enrollees cared for by nonparticipating groups. Savings were small and fully shared with providers, which suggests no significant effect on total spending (including bonuses). Our qualitative analysis suggested that early in the program, many physicians were not fully engaged with the initiative and did not make full use of its tools. These findings imply that this and similar payment reforms may require greater time to realize significant savings than many stakeholders had expected. Patience may be necessary if payer-led reform is going to lead to system transformation.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Early Impact Of CareFirst's Patient-Centered Medical Home With Strong Financial Incentives
View DOI Record
View the PubMed citation for Early Impact Of CareFirst's Patient-Centered Medical Home With Strong Financial Incentives178
eConsult Mental Health: Electronic Referral and Consultation to Integrate Primary Care and Mental Health
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
HIT & Telehealth
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for eConsult Mental Health: Electronic Referral and Consultation to Integrate Primary Care and Mental Health
View DOI Record
View the PubMed citation for eConsult Mental Health: Electronic Referral and Consultation to Integrate Primary Care and Mental Health179
Educating health professionals collaboratively for team-based primary care
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: Team-based primary care offers the potential to dramatically improve the quality and efficiency of care, but its broader adoption is hindered by an education system that trains health professions in silos. Collaborative models that educate multiple practitioners together are needed to create a new generation of health professionals able to work in efficiently functioning teams. Changes in professional cultures, organizational structures, clinical partnerships, admissions, accreditation, and funding models will be required to support the expansion of collaborative education effectively.
Topic(s):
Education & Workforce
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Educating health professionals collaboratively for team-based primary care
View DOI Record
View the PubMed citation for Educating health professionals collaboratively for team-based primary care