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The Literature Collection contains over 11,000 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).
619 Results
383
Participatory (re)design of a sociotechnical healthcare delivery system: The Group Health Patient-Centered Medical Home
Type: Journal Article
Year: 2010
Publication Place: Netherlands
Abstract: This paper describes one organization's interpretation of the Patient-Centered Medical Home concept and the healthcare delivery system that has emerged from their participatory redesign initiative. Group Health, a large integrated healthcare system based in Seattle, Washington, USA initiated a Patient-Centered Medical Home care delivery system transformation in January 2007. Current theories and evidence about the Patient-Centered Medical Home (PCMH), the Chronic Care Model, and effective primary care were interpreted via a facilitated group process and translated into a core set of 5 system design principles. These design principles guided all subsequent system transformation activities. The central organizing principle is supporting and sustaining the patient-primary care physician relationship. The emergent PCMH healthcare delivery system comprises both opportunistic point-of-care and outreach components, many of which leverage and enhance the organization's health information and communication technologies.
Topic(s):
Medical Home
See topic collection
384
Partnering with a payer to develop a value-based medical home pilot: a West Coast practice's experience
Type: Journal Article
Year: 2012
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Medical Home
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Reference Links: View the PubMed citation for Partnering with a payer to develop a value-based medical home pilot: a West Coast practice's experience
389
Patient outcomes at 26 months in the patient-centered medical home National Demonstration Project
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: PURPOSE: The purpose of this study was to evaluate patient outcomes in the National Demonstration Project (NDP) of practices' transition to patient-centered medical homes (PCMHs). METHODS: In 2006, a total of 36 family practices were randomized to facilitated or self-directed intervention groups. Progress toward the PCMH was measured by independent assessments of how many of 39 predominantly technological NDP model components the practices adopted. We evaluated 2 types of patient outcomes with repeated cross-sectional surveys and medical record audits at baseline, 9 months, and 26 months: patient-rated outcomes and condition-specific quality of care outcomes. Patient-rated outcomes included core primary care attributes, patient empowerment, general health status, and satisfaction with the service relationship. Condition-specific outcomes were measures of the quality of care from the Ambulatory Care Quality Alliance (ACQA) Starter Set and measures of delivery of clinical preventive services and chronic disease care. RESULTS: Practices adopted substantial numbers of NDP components over 26 months. Facilitated practices adopted more new components on average than self-directed practices (10.7 components vs 7.7 components, P=.005). ACQA scores improved over time in both groups (by 8.3% in the facilitated group and by 9.1% in the self-directed group, P <.0001) as did chronic care scores (by 5.2% in the facilitated group and by 5.0% in the self-directed group, P=.002), with no significant differences between groups. There were no improvements in patient-rated outcomes. Adoption of PCMH components was associated with improved access (standardized beta [Sbeta]=0.32, P = .04) and better prevention scores (Sbeta=0.42, P=.001), ACQA scores (Sbeta=0.45, P = .007), and chronic care scores (Sbeta=0.25, P =.08). CONCLUSIONS: After slightly more than 2 years, implementation of PCMH components, whether by facilitation or practice self-direction, was associated with small improvements in condition-specific quality of care but not patient experience. PCMH models that call for practice change without altering the broader delivery system may not achieve their intended results, at least in the short term.
Topic(s):
Medical Home
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Reference Links:
View the DOI record for Patient outcomes at 26 months in the patient-centered medical home National Demonstration Project
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View the PubMed citation for Patient outcomes at 26 months in the patient-centered medical home National Demonstration Project390
Patient predictors and utilization of health services within a medical home for homeless persons
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Healthcare Disparities
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, Medical Home
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Reference Links:
View the DOI record for Patient predictors and utilization of health services within a medical home for homeless persons
View DOI Record
View the PubMed citation for Patient predictors and utilization of health services within a medical home for homeless persons391
Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Healthcare Disparities
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, Medical Home
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392
Patient-Centered Homes and Integrated Behavioral Health Care: Reclaiming the Role of "Consultant" for Psychiatric-Mental Health Nurse Practitioner
Type: Journal Article
Year: 2016
Publication Place: England
Abstract: The notion of patient-centered care has long been linked with nursing practice since Florence Nightingale. The discipline of nursing is focused on the holistic care of individuals, families, and communities in times of sickness and/or health. However, in psychiatric-mental health nursing, the concepts of mental health and psychiatric illness still remain marginalized in our health care delivery systems, as well as in nursing education, knowledge development, and practice. Even with the concept of patient-centered homes, acute and primary care providers are reluctant to embrace care of those with psychiatric illness in their respective settings. Psychiatric illness was and continues to be in the shadows, hidden and often ignored by the larger community as well as by health care providers. This paper describes a Health Resources Services Administration (HRSA) Advanced Nursing Education (ANE) training grant's objective of reintegrating psychiatric-mental health practice into ALL health care delivery systems using the concept of patient-centered nursing care as a foundation for, and promotion of, the Psychiatric-Mental Health Nurse Practitioner (PMH-NP) as the "navigator" for not only the patients and their families, but also for their acute and primary care colleagues using an Interprofessional Education Model. The major barriers and lessons learned from this project as well as the need for psychiatric-mental health nurses to reclaim their role as a consultant/liaison in acute, primary, and long-term care settings will be discussed. The PMHNP as a consultant/liaison is being revitalized as an innovative advanced practice nursing health care model in North Carolina.
Topic(s):
Education & Workforce
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, Medical Home
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395
Patient-centered medical home and quality measurement in small practices
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: OBJECTIVES: To assess performance on quality measures among small primary care practices that recently adopted an electronic health record (EHR), and how performance differs between practices that have achieved patient-centered medical home (PCMH) recognition and those that have not. STUDY DESIGN: Retrospective cohort study. METHODS: Comparison of practice characteristics and performance on quality measures across 150 independent practices from 2009 to 2011 by recognition status for Physician Practice Connections-PCMH. RESULTS: PCMH-recognized practices performed significantly better than nonrecognized practices on 5 out of 7 clinical quality measures at baseline, and the differences were maintained over the 2-year study period. Both groups improved on all clinical quality measures. Though the magnitude of differences was small, PCMHrecognized practices had a higher number of patients diagnosed with hypertension and proportionally more black patients. A significant difference in PCMH-recognized practices is that they received, on average, 4 additional quality improvement visits compared with nonrecognized practices. CONCLUSIONS: Among small practices that have adopted EHRs, practices with PCMH recognition consistently outperformed practices without recognition on most clinical quality measures. With adequate assistance, small, resource-strapped practices can continue to have higher performance on clinical quality measures.
Topic(s):
HIT & Telehealth
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, Medical Home
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, Measures
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Reference Links: View the PubMed citation for Patient-centered medical home and quality measurement in small practices
396
Patient-Centered Medical Home Care for Adolescents in Need of Mental Health Treatment
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Healthcare Disparities
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, Medical Home
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Reference Links: View the PubMed citation for Patient-Centered Medical Home Care for Adolescents in Need of Mental Health Treatment
397
Patient-centered medical home cyberinfrastructure current and future landscape
Type: Journal Article
Year: 2011
Publication Place: Netherlands
Topic(s):
Medical Home
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Reference Links:
View the DOI record for Patient-centered medical home cyberinfrastructure current and future landscape
View DOI Record
View the PubMed citation for Patient-centered medical home cyberinfrastructure current and future landscape398
Patient-centered medical home initiative produced modest economic results for Veterans Health Administration, 2010-12
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: In 2010 the Veterans Health Administration (VHA) began a nationwide initiative called Patient Aligned Care Teams (PACT) that reorganized care at all VHA primary care clinics in accordance with the patient-centered medical home model. We analyzed data for fiscal years 2003-12 to assess how trends in health care use and costs changed after the implementation of PACT. We found that PACT was associated with modest increases in primary care visits and with modest decreases in both hospitalizations for ambulatory care-sensitive conditions and outpatient visits with mental health specialists. We estimated that these changes avoided $596 million in costs, compared to the investment in PACT of $774 million, for a potential net loss of $178 million in the study period. Although PACT has not generated a positive return, it is still maturing, and trends in costs and use are favorable. Adopting patient-centered care does not appear to have been a major financial risk for the VHA.
Topic(s):
Medical Home
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Reference Links:
View the DOI record for Patient-centered medical home initiative produced modest economic results for Veterans Health Administration, 2010-12
View DOI Record
View the PubMed citation for Patient-centered medical home initiative produced modest economic results for Veterans Health Administration, 2010-12399
Patient-Centered Medical Home Membership Is Associated with Decreased Hospital Admissions for Emergency Department Behavioral Health Patients
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: The objective was to examine the impact of a multipayer patient-centered medical home (PCMH) on health care utilization for behavioral health patients seen at a tertiary care emergency department (ED). A retrospective health records review was performed for PCMH and non-PCMH patients who presented and received a psychiatric consultation during a 2-year period in the ED of the Mayo Clinic Hospital in Rochester, Minnesota. Univariable and multivariable associations with the outcomes of admission and return visits within 72 hours were evaluated using logistic regression models and summarized with odds ratios (ORs) and 95% confidence intervals (CIs). There were 5398 visits among 3815 patients during the study period. Among these, there were 2440 (45%) PCMH patient visits. There were 2983 (55%) total patient visits resulting in an admission. In a univariable model, PCMH patients (53%) were less likely to be admitted from the ED compared with non-PCMH patients (57%) (OR 0.84; 95% CI 0.76-0.94; P = 0.002) and this remained statistically significant (OR 0.83; 95% CI 0.74-0.93; P = 0.001) after multivariable adjustment. Among the 2415 non-admitted patients, there was no significant difference in returns within 72 hours between PCMH patients (13%) and non-PCMH patients (12%) (OR 1.12; 95% CI 0.83-1.43; P = 0.36). PCMH membership was associated with a lower probability of inpatient hospitalization from the ED. PCMH interventions may be associated with a reduction in health care utilization.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
400
Patient-Centered Medical Home Membership Is Associated with Decreased Hospital Admissions for Emergency Department Behavioral Health Patients
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: The objective was to examine the impact of a multipayer patient-centered medical home (PCMH) on health care utilization for behavioral health patients seen at a tertiary care emergency department (ED). A retrospective health records review was performed for PCMH and non-PCMH patients who presented and received a psychiatric consultation during a 2-year period in the ED of the Mayo Clinic Hospital in Rochester, Minnesota. Univariable and multivariable associations with the outcomes of admission and return visits within 72 hours were evaluated using logistic regression models and summarized with odds ratios (ORs) and 95% confidence intervals (CIs). There were 5398 visits among 3815 patients during the study period. Among these, there were 2440 (45%) PCMH patient visits. There were 2983 (55%) total patient visits resulting in an admission. In a univariable model, PCMH patients (53%) were less likely to be admitted from the ED compared with non-PCMH patients (57%) (OR 0.84; 95% CI 0.76-0.94; P = 0.002) and this remained statistically significant (OR 0.83; 95% CI 0.74-0.93; P = 0.001) after multivariable adjustment. Among the 2415 non-admitted patients, there was no significant difference in returns within 72 hours between PCMH patients (13%) and non-PCMH patients (12%) (OR 1.12; 95% CI 0.83-1.43; P = 0.36). PCMH membership was associated with a lower probability of inpatient hospitalization from the ED. PCMH interventions may be associated with a reduction in health care utilization.
Topic(s):
Medical Home
See topic collection