Literature Collection

341

Medical Home Features of VHA Primary Care Clinics and Avoidable Hospitalizations

Type: Journal Article

Year: 2013

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342

Medical home for adolescents: low attainment rates for those with mental health problems and other vulnerable groups

Type: Journal Article

Authors: S. H. Adams, P. W. Newacheck, M. J. Park, C. D. Brindis, C. E. Irwin

Year: 2013

Publication Place: United States

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343

Medical Home Implementation Gaps for Seniors: Perceptions and Experiences of Primary Care Medical Practices

Type: Journal Article

Authors: Timothy Hoff, Matthew DePuccio

Year: 2018

Publication Place: Thousand Oaks, California

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344

Medical Home Practice-Based Care Coordination

Type: Report

Authors: J. W. McAllister, E. Presler, Cooley. W. C.

Year: 2007

Publication Place: Greenfield, New Hampshire

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,

Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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345

Medical home services for children with behavioral health conditions

Type: Journal Article

Authors: R. C. Sheldrick, E. C. Perrin

Year: 2010

Publication Place: United States

Abstract: OBJECTIVES: Whether medical services received by children and youth with behavioral health conditions are consistent with a Medical Home has not been systematically studied. The objectives of this study were to examine the variation among four behavioral health conditions in regard to services related to the Medical Home. METHODS: Cross-sectional analyses of the 2003 National Survey of Children's Health were conducted. Multiple logistic regression analyses tested the impact of behavioral health conditions on medical needs, on Medical Home components, and on likelihood of having a Medical Home overall. RESULTS: Autism, Depression/Anxiety, and Behavior/Conduct problems were associated with reduced likelihood of having a Medical Home, whereas Attention-Deficit Hyperactivity Disorder was associated with increased likelihood. All health conditions predicted increased access to a primary care physician (PCP) and a preventive visit in the past year. However, all were also associated with higher needs for specialty care and all behavioral health conditions except Attention-Deficit Hyperactivity Disorder were associated with difficulties accessing this care. CONCLUSIONS: A detailed examination of the receipt of services among children and youth with behavioral health conditions reveals two primary reasons why such care is less likely to be consistent with a Medical Home model: (1) parents are more likely to report needing specialty care; and (2) these needs are less likely to be met. These data suggest that the reason why services received by children and youth with behavioral health conditions are not consistent with the Medical Home has more to do with difficulty accessing specialty care than with problems accessing quality primary care.

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346

Medical homes for at-risk children: Parental reports of clinician-parent relationships, anticipatory guidance, and behavior changes

Type: Journal Article

Authors: C. S. Nelson, S. M. Higman, C. Sia, E. McFarlane, L. Fuddy, A. K. Duggan

Year: 2005

Abstract: BACKGROUND: Family-centeredness, compassion, and trust are 3 attributes of the clinician-parent relationship in the medical home. Among adults, these attributes are associated with patients' adherence to clinicians' advice. OBJECTIVES: The objectives were (1) to measure medical home attributes related to the clinician-parent relationship, (2) to measure provision of anticipatory guidance regarding injury and illness prevention, (3) to relate anticipatory guidance to parental behavior changes, and (4) to relate medical home attributes to anticipatory guidance and parental behavior changes. METHODS: A cross-sectional study of data collected among at-risk families when children were 1 year of age, in a randomized, controlled trial of a home-visiting program to prevent child abuse and neglect, was performed. Modified subscales of the Primary Care Assessment Survey were used to measure parental ratings of clinicians' family-centeredness, compassion, and trust. Parental reports of provision of anticipatory guidance regarding injury and illness prevention topics (smoke alarms, infant walkers, car seats, hot water temperature, stair guards, sunscreen, firearm safety, and bottle propping) and behavior changes were recorded. RESULTS: Of the 564 mothers interviewed when their children were 1 year of age, 402 (71%) had a primary care provider and had complete data for anticipatory guidance items. By definition, poverty, partner violence, poor maternal mental health, and maternal substance abuse were common in the study sample. Maternal ratings of clinicians' family-centeredness, compassion, and trust were fairly high but ranged widely and varied among population subgroups. Families reported anticipatory guidance for a mean of 4.6 +/- 2.2 topics relevant for discussion. Each medical home attribute was positively associated with parental reports of completeness of anticipatory guidance, ie, family-centeredness (beta = .026, SE = .004), compassion (beta = .019, SE = .005), and trust (beta = .016, SE = .005). Parents' perceptions of behavior changes were positively associated with trust (beta = .018, SE = .006). Analyses were adjusted for potential confounding by randomized, controlled trial group assignment, receipt of >or=5 well-child visits, and baseline attributes. CONCLUSIONS: Among at-risk families, we found an association between parental ratings of the medical home and parental reports of the completeness of anticipatory guidance regarding selected injury and illness prevention topics. Parents' trust of the clinician was associated with parent-reported behavior changes for discussed topics.

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347

Medical Homes Versus Individual Practice in Primary Care: Impact on Health Care Expenditures.

Type: Journal Article

Authors: Julian Perelman, Isabelle Roch, Isabelle Heymans, Catherine Moureaux, Raphael Lagasse, Lieven Annemans, Marie-Christine Closon

Year: 2013

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348

Medical homes: "Where you stand on definitions depends on where you sit."

Type: Journal Article

Authors: Joshua R. Vest, Jane N. Bolin, Thomas R. Miller, Larry D. Gamm, Thomas E. Siegrist, Luis E. Martinez

Year: 2010

Publication Place: US: Sage Publications

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349

Meeting evolving workforce needs: Preparing psychologists for leadership in the patient-centered medical home

Type: Journal Article

Authors: A. O. Beacham, K. S. Van Sickle, P. Khatri, M. K. Ali, D. Reimer, E. W. Farber, N. J. Kaslow

Year: 2017

Publication Place: United States

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350

Mental and behavioral health screening at preventive visits: opportunities for follow-up of patients who are nonadherent with the next preventive visit

Type: Journal Article

Authors: K. A. Hacker, L. N. Arsenault, S. Williams, A. M. Digirolamo

Year: 2011

Publication Place: United States

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351

Mental health care integration and primary care patient experience in the Veterans Health Administration

Type: Journal Article

Authors: L. B. Leung, D. Rose, R. Guo, C. E. Brayton, L. V. Rubenstein, S. Stockdale

Year: 2021

Abstract:

BACKGROUND: Mental health specialists and care managers facilitate comprehensive care provision within medical homes. Despite implementation challenges, mental health integration is thought to improve patient-centered primary care. OBJECTIVES: To examine the relationship between primary care patient experience and mental health integration. RESEARCH DESIGN: Cross-sectional surveys from 168 primary care clinicians (PCPs) (n = 226) matched with assigned patients' surveys (n = 1734) in one Veterans Health Administration (VA) region, fiscal years 2012-2013. Multilevel regression models examined patient experience and mental health integration, adjusting for patient and PCP characteristics. MEASURES: Patient experience outcomes were (1) experience with PCP and (2) receipt of comprehensive care, such as talked about "stress". Independent variables represented mental health integration- (1) PCP-rated communication with mental health and (2) proportion of clinic patients who saw integrated specialists. RESULTS: 50% and 43% of patients rated their PCPs 10/10 and reported receiving comprehensive care, respectively. Neither patient experience or receipt of comprehensive care was significantly associated with PCP's ratings of communication with mental health, nor with proportion of clinic patients who saw integrated specialists. Among a subsample of patients who rated their mental health as poor/fair, however, we detected an association between proportion of clinic patients who saw integrated specialists and patient experience (odds ratio = 1.05, 95% confidence interval = 1.01-1.09, p = .01). CONCLUSIONS: No association was observed between mental health integration and primary care patients' reported care experiences, but a significant association existed among patients who reported poor/fair mental health. More research is needed to understand patient experiences with regard to care model implementation.

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352

Mental Health Integration in Geriatric Patient-Aligned Care Teams in the Department of Veterans Affairs

Type: Journal Article

Authors: J. Moye, G. Harris, E. Kube, B. Hicken, O. Adjognon, K. Shay, J. L. Sullivan

Year: 2019

Publication Place: England

Abstract: OBJECTIVES: To inform geriatric mental health policy by describing the role of behavioral healthcare providers within a geriatric patient-aligned care team (GeriPACT), a patient-centered medical home model of care within the Veterans Health Administration (VHA), serving older veterans with chronic disease, functional dependency, cognitive decline, and psychosocial challenges, and/or those who have elder abuse, risk of long-term care placement, or impending disability. METHODS: The authors used mixed methods, consisting of a national survey and site visits between July 2016 and February 2017, at VHA outpatient clinics. The participants, 101 GeriPACTs at 44 sites, completed surveys, and 24 medical providers were interviewed. A standardized survey and semi-structured interview guide were developed based on the program handbook, with input from experts in the VHA Office of Geriatrics and Extended Care Services, guided by the Consolidated Framework for Implementation Science Research. RESULTS: Of surveyed GeriPACTs, 42.6% had a mental health provider on the team-a psychiatrist (28.7%) and/or psychologist (23.8%). Of these, the mean was 0.27 full-time equivalent psychiatrists and 0.44 full-time equivalent psychologists per team (suggested panel=800 patients). In surveys, teams with behavioral health providers were more likely to manage psychosocial chi(2)=8.87, cognitive chi(2)=8.68, and depressive chi(2)=11.85 conditions in their panel than those without behavioral health providers. CONCLUSION: GeriPACT mental health integration is less than 50%. Population differences between general primary care and geriatric primary care may require different care approaches and provider competencies and need further study.

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353

Mental health recovery in the patient-centered medical home

Type: Web Resource

Authors: Marisa Sklar

Year: 2015

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,

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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354

Mental health services for children and adolescents

Type: Journal Article

Authors: Stuart W. Teplin, Katherine E. Murray

Year: 2009

Publication Place: US: Lippincott Williams & Wilkins

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355

Mental Health Services in the Medical Home in the Department of Veterans Affairs: Factors for Successful Integration

Type: Journal Article

Authors: A. S. Pomerantz, L. K. Kearney, L. O. Wray, E. P. Post, J. F. McCarthy

Year: 2014

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356

Mental health specialty care in the medical home

Type: Journal Article

Authors: B. Starfield

Year: 2009

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357

Mental health treatment in the primary care setting: Patterns and pathways

Type: Journal Article

Authors: S. Petterson, B. F. Miller, J. C. Payne-Murphy, R. L. Phillips

Year: 2014

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358

Mental health, race and ethnicity, and medical home in children with special health care needs

Type: Journal Article

Authors: Jessica E. Rast, Tamara Garfield, Tobechukwu H. Ezeh, Kristy A. Anderson

Year: 2024

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359

Mental health, substance abuse, and health behavior services in patient-centered medical homes

Type: Journal Article

Authors: R. Kessler, B. F. Miller, M. Kelly, D. Graham, A. Kennedy, B. Littenberg, C. D. MacLean, C. van Eeghen, S. H. Scholle, M. Tirodkar, S. Morton, W. D. Pace

Year: 2014

Publication Place: United States

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360

Methods for evaluating practice change toward a patient-centered medical home

Type: Journal Article

Authors: C. R. Jaen, B. F. Crabtree, R. F. Palmer, R. L. Ferrer, P. A. Nutting, W. L. Miller, E. E. Stewart, R. Wood, M. Davila, K. C. Stange

Year: 2010

Publication Place: United States

Abstract: PURPOSE: Understanding the transformation of primary care practices to patient-centered medical homes (PCMHs) requires making sense of the change process, multilevel outcomes, and context. We describe the methods used to evaluate the country's first national demonstration project of the PCMH concept, with an emphasis on the quantitative measures and lessons for multimethod evaluation approaches. METHODS: The National Demonstration Project (NDP) was a group-randomized clinical trial of facilitated and self-directed implementation strategies for the PCMH. An independent evaluation team developed an integrated package of quantitative and qualitative methods to evaluate the process and outcomes of the NDP for practices and patients. Data were collected by an ethnographic analyst and a research nurse who visited each practice, and from multiple data sources including a medical record audit, patient and staff surveys, direct observation, interviews, and text review. Analyses aimed to provide real-time feedback to the NDP implementation team and lessons that would be transferable to the larger practice, policy, education, and research communities. RESULTS: Real-time analyses and feedback appeared to be helpful to the facilitators. Medical record audits provided data on process-of-care outcomes. Patient surveys contributed important information about patient-rated primary care attributes and patient-centered outcomes. Clinician and staff surveys provided important practice experience and organizational data. Ethnographic observations supplied insights about the process of practice development. Most practices were not able to provide detailed financial information. CONCLUSIONS: A multimethod approach is challenging, but feasible and vital to understanding the process and outcome of a practice development process. Additional longitudinal follow-up of NDP practices and their patients is needed.

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