Literature Collection

361

Depression, anxiety, pain and chronic opioid management in primary care: Type II effectiveness-implementation hybrid stepped wedge cluster randomized trial

Type: Journal Article

Authors: E. G. Price-Haywood, J. Burton, J. Harden-Barrios, A. Bazzano, J. Lefante, L. Shi, R. N. Jamison

Year: 2020

Publication Place: United States

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362

Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study

Type: Journal Article

Authors: J. Unutzer, D. L. Patrick, G. Simon, D. Grembowski, E. Walker, C. Rutter, W. Katon

Year: 1997

Publication Place: UNITED STATES

Abstract: OBJECTIVE: To examine whether depressive symptoms in older adults contribute to increased cost of general medical services. DESIGN: A 4-year prospective cohort study. SETTING: Four primary care clinics of a large staff-model health maintenance organization (HMO) in Seattle, Wash. PATIENTS: A total of 5012 Medicare enrollees older than 65 years were invited to participate in the study; 2558 subjects (51%) were successfully enrolled. Non-participants were somewhat older and had a higher level of chronic medical illness. MAIN OUTCOME MEASURES: Depressive symptoms as measured by the Center for Epidemiological Studies Depression scale, which was administered as part of a mail survey at baseline, at 2 years, and at 4 years; and total cost of medical services from the perspective of the HMO. Data were obtained from the cost accounting system of the HMO. RESULTS: In this cohort of older adults, depressive symptoms were common, persistent, and associated with a significant increase in the cost of general medical services. This increase was seen for every component of health care costs and was not accounted for by an increase in specialty mental health care. The increase in health care costs remained significant after adjusting for differences in age, sex, and chronic medical illness. CONCLUSIONS: Depressive symptoms in older adults are associated with a significant increase in the cost of medical services, even after adjusting for the severity of chronic medical illness.

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363

Design and implementation of the telemedicine-enhanced antidepressant management study

Type: Journal Article

Authors: J. C. Fortney, J. M. Pyne, M. J. Edlund, D. E. Robinson, D. Mittal, K. L. Henderson

Year: 2006

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364

Designing Medicaid Health Homes for People with Opioid Dependency: Considerations for States

Type: Government Report

Authors: K. Moses, J. Klebonis

Year: 2015

Abstract: Although individuals with opioid dependency represent a small percentage of all Medicaid enrollees, they often have significant physical and behavioral health needs that result in high costs of care. States are looking for innovative, cost-effective ways to integrate and coordinate care for this high-need population. Through the Affordable Care Act, states can implement health homes to provide enhanced integration and care coordination for people with opioid dependency.

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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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365

Designing payment for collaborative care for depression in primary care

Type: Journal Article

Authors: Y. Bao, L. P. Casalino, S. L. Ettner, M. L. Bruce, L. I. Solberg, J. Unutzer

Year: 2011

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366

Developing a Bold Vision to Achieve Physical-Behavioral Health Integration in Medi-Cal

Type: Report

Authors: Logan Kelly

Year: 2019

Topic(s):

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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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367

Developing an integrated primary care practice: Strategies, techniques, and a case illustration

Type: Journal Article

Authors: Barbara B. Walker, Charlotte A. Collins

Year: 2009

Publication Place: US: John Wiley & Sons

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368

Developing Telemental Health Partnerships Between State Medical Schools and Federally Qualified Health Centers: Navigating the Regulatory Landscape and Policy Recommendations

Type: Journal Article

Authors: John C. Fortney, Richard C. Veith, Amy M. Bauer, Paul N. Pfeiffer, Marcia Valenstein, Jeffrey M. Pyne, Gregory W. Dalack, Teresa L. Kramer, Lori J. Ferro, Karla Metzger, Jay H. Shore, Andrew D. Carlo, Sara Coates, Susan Ward-Jones, Ed Larkins, Erin Hafer, Stephanie Shushan, Donald L. Weaver, Jurgen Unutzer

Year: 2019

Publication Place: England

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369

Development and Implementation of a Team-Based, Primary Care Delivery Model: Challenges and Opportunities

Type: Journal Article

Year: 2019

Publication Place: England

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370

Development and validation of health system performance measures for opioid use disorder in British Columbia, Canada

Type: Journal Article

Authors: B. Nosyk, J. E. Min, L. A. Pearce, H. Zhou, F. Homayra, L. Wang, M. Piske, D. McCarty, G. Gardner, W. O'Briain, E. Wood, P. Daly, T. Walsh, B. Henry

Year: 2022

Publication Place: Ireland

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371

Development and validation of health system performance measures for opioid use disorder in British Columbia, Canada

Type: Journal Article

Authors: B. Nosyk, J. E. Min, L. A. Pearce, H. Zhou, F. Homayra, L. Wang, M. Piske, D. McCarty, G. Gardner, W. O'Briain, E. Wood, P. Daly, T. Walsh, B. Henry

Year: 2022

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372

Diabetes group visits: integrated medical care and behavioral support to improve diabetes care and outcomes from a primary care perspective

Type: Journal Article

Authors: S. A. Eisenstat, K. Ulman, A. L. Siegel, K. Carlson

Year: 2013

Publication Place: United States

Abstract: Of the many innovations in health care delivery proposed in the context of health reform for those with chronic diseases such as diabetes, the group visit model is relatively easy to implement and is effective for improving health outcomes and patient and provider satisfaction, with a neutral to positive effect on health care costs. This article describes the evolution of group visits for those with diabetes, the theory underlying group visits for patients with chronic medical conditions, and the existing evidence for the effectiveness of this model. It also addresses implementation of groups in practice, with an emphasis on the practical aspects of program implementation, integration of behavioral expertise into medical groups, individualization in various practice settings, and reimbursement issues.

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373

Diagnosis and treatment of substance use disorder among pregnant women in three state Medicaid programs from 2013 to 2016

Type: Journal Article

Authors: V. Lynch, L. Clemans-Cope, E. Howell, I. Hill

Year: 2021

Publication Place: United States

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374

Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study

Type: Journal Article

Authors: R. Williams, D. A. Jenkins, D. M. Ashcroft, B. Brown, S. Campbell, M. J. Carr, S. Cheraghi-Sohi, N. Kapur, O. Thomas, R. T. Webb, N. Peek

Year: 2020

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375

Did Arkansas' Medicaid Patient-Centered Medical Home Program Have Spillover Effects on Commercially Insured Enrollees?

Type: Journal Article

Authors: Jesse M. Hinde, Nathan West, Samuel J. Arbes III, Marianne Kluckman, Suzanne L. West

Year: 2020

Publication Place: Thousand Oaks, California

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376

Differences in Medicaid expansion effects on buprenorphine treatment utilization by county rurality and income: A pharmacy data claims analysis from 2009-2018

Type: Journal Article

Authors: O. K. Golan, F. Sheng, A. W. Dick, M. Sorbero, D. J. Whitaker, B. Andraka-Christou, T. Pigott, A. J. Gordon, B. D. Stein

Year: 2023

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377

Differences in medical care expenditures for adults with depression compared to adults with major chronic conditions

Type: Journal Article

Authors: I. Z. Lurie, L. M. Manheim, D. D. Dunlop

Year: 2009

Publication Place: Italy

Abstract: BACKGROUND: Approximately 17.1 million adults report having a major depressive episode in 2004 which represents 8% of the adult population in the U.S. Of these, more than one-third did not seek treatment. In spite of the large and extensive literature on the cost of mental health, we know very little about the differences in out-of-pocket expenditures between adults with depression and adults with other major chronic disease and the sources of those expenditures. AIMS: For persons under age 65, compare total and out-of-pocket expenditures of those with depression to non-depressed individuals who have another major chronic disease. METHODS: This study uses two linked, nationally representative surveys, the 1999 National Health Interview Survey (NHIS) and the 2000 Medical Expenditure Panel Survey (MEPS), to identify the population of interest. Depression was systematically assessed using a short form of the World Health Organization's (WHO) Composite International Diagnostic Interview--Short Form (CIDI-SF). To control for differences from potentially confounding factors, we matched depressed cases to controls using propensity score matching. RESULTS: We estimate that persons with depression have about the same out-of-pocket expenditures while having 11.8% less total medical expenditures (not a statistically significant difference) compared to non-depressed individuals with at least one chronic disease. DISCUSSION: High out-of-pocket expenditures are a concern for individuals with chronic diseases. Our study shows that those with depression have comparable out-of-pocket expenses to those with other chronic diseases, but given their lower income levels, this may result in a more substantial financial burden. IMPLICATION FOR POLICY: High out-of-pocket expenditures are a concern for individuals with depression and other chronic diseases. For both depressed individuals and non-depressed individuals with other chronic diseases, prescription drug expenditures contribute most to out-of-pocket expenses. Given the important role medications play in treatment of depression, high copayment rates are a concern for limiting compliance with appropriate treatment.

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378

Direct costs associated with mild cognitive impairment in primary care

Type: Journal Article

Authors: M. Luppa, S. Heinrich, H. Matschinger, A. Hensel, T. Luck, S. G. Riedel-Heller, H. H. Konig

Year: 2008

Publication Place: England

Abstract: BACKGROUND/AIMS: Little is known about the direct costs of individuals with Mild Cognitive Impairment (MCI). This study investigates the direct costs associated with MCI according to recent diagnostic criteria from a societal perspective. METHODS: Four hundred and fifty-two primary care patients aged 75+ from Leipzig, Germany, were investigated in face-to-face interviews regarding MCI according to the current diagnostic criteria of the International Working Group on MCI, resource utilisation and costs (questionnaire of service utilisation and costs), as well as chronic medical illness (Chronic Disease Score). Resource utilisation was monetarily valued using 2004/2005 prices. RESULTS: Mean annual direct costs were 4,443 euro for patients with MCI (n=39) and 3,814 euro for patients without MCI (n=413) (p=0.34). Looking at the cost components, patients with and without MCI only significantly differed regarding pharmaceutical costs (1,210 euro vs 1,062 euro; p<0.05) not caused by antidementive drugs. CONCLUSION: Direct costs of individuals having MCI are not significantly increased in comparison to direct costs of individuals without cognitive deficits.

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379

Disparities in Access to Health Care Among US-Born and Foreign-Born US Adults by Mental Health Status, 2013-2016

Type: Journal Article

Authors: R. Dedania, G. Gonzales

Year: 2019

Publication Place: United States

Abstract: Objectives. To compare access to care between US-born and foreign-born US adults by mental health status. Methods. We analyzed data on nonelderly adults (n = 100 428) from the 2013-2016 National Health Interview Survey. We used prevalence estimates and multivariable logistic regression models to compare issues of affordability and accessibility between US-born and foreign-born individuals. Results. Approximately 22.2% of US-born adults and 18.1% of foreign-born adults had symptoms of moderate to severe psychological distress. Compared with US-born adults with no psychological distress, and after adjustment for sociodemographic characteristics, US-born and foreign-born adults with psychological distress were much more likely to report multiple emergency room visits and unmet medical care, mental health care, and prescription medications because of cost. Conclusions. Our study found that adults with moderate to severe psychological distress, regardless of their immigration status, were at greater risk for reporting issues of affordability when accessing health care compared with US-born adults with no psychological distress. Public Health Implications. Health care and mental health reforms should focus on reducing health care costs and establishing innovative efforts to broaden access to care to diverse populations.

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380

Disparities in receipt of medications for opioid use disorder among pregnant women

Type: Journal Article

Authors: L. E. Henkhaus, M. B. Buntin, S. C. Henderson, P. Lai, S. W. Patrick

Year: 2021

Publication Place: United States

Abstract:

Background: Medications for opioid use disorder (MOUD) improve outcomes for pregnant women and infants. Our primary aim was to examine disparities in maternal MOUD receipt by family sociodemographic characteristics. Methods: This retrospective cohort study included mother-infant dyads with Medicaid-covered deliveries in Tennessee from 2009 to 2016. First, we examined family sociodemographic characteristics - including race/ethnicity, rurality, mother's primary language and education level, and whether paternity was recorded in birth records - and newborn outcomes by type of maternal opioid use. Second, among pregnant women with OUD, we used logistic regression to measure disparities in receipt of MOUD by family sociodemographic characteristics including interactions between characteristics. Results: Our cohort from Medicaid-covered deliveries consisted of 314,965 mother-infant dyads, and 4.2 percent were exposed to opioids through maternal use. Among dyads with maternal OUD, MOUD receipt was associated with lower rates of preterm and very preterm birth. Logistic regression adjusted for family sociodemographic characteristics showed that pregnant women with OUD in rural versus urban areas (aOR: 0.66; 95% CI: 0.60-0.72) and who were aged ≥35 years versus ≤25 years (aOR: 0.75; 95% CI: 0.64-0.89) were less likely to have received MOUD. Families in which the mother's primary language was English (aOR: 2.47; 95% CI: 1.24-4.91) and paternity was recorded on the birth certificate (aOR: 1.30; 95% CI: 1.19-1.42) were more likely to have received MOUD. Regardless of high school degree attainment, non-Hispanic Black versus non-Hispanic White race was associated with lower likelihood of MOUD receipt. Hispanic race was associated with lower likelihood of MOUD receipt among women without a high school degree. Conclusions: Among a large cohort of pregnant women, we found disparities in receipt of MOUD among non-Hispanic Black, Hispanic, and rural pregnant women. As policymakers consider strategies to improve access to MOUD, they should consider targeted approaches to address these disparities.

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