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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
401
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
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, Medical Home
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403
Patient-centered medical home: how it affects psychosocial outcomes for diabetes
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: Fragmentation of the current U.S. health care system and the increased prevalence of chronic diseases in the U.S. have led to the recognition that new models of care are needed. Chronic disease management, including diabetes, is often accompanied by a myriad of associated psychosocial issues that need to be addressed as part of a comprehensive treatment plan. Diabetes care should be aligned with comprehensive whole-person health care. The patient-centered medical home (PCMH) has emerged as a model for enhanced primary care that focuses on comprehensive integrated care. PCMH demonstration projects have shown improvements in quality of care, patient experience, care coordination, access to care, and quality measures for diabetes. Key PCMH transformative features associated with psychosocial issues related to diabetes reviewed in this article include integration of mental and behavioral health, care management/coordination, payment reform, advanced access, and putting the patient at the center of health care. This article also reviews the evidence supporting comprehensive and integrated care for addressing psychosocial issues associated with diabetes in the medical home.
Topic(s):
Medical Home
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Reference Links: 
View the DOI record for Patient-centered medical home: how it affects psychosocial outcomes for diabetes
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View the PubMed citation for Patient-centered medical home: how it affects psychosocial outcomes for diabetes404
Patient-centered medical home: Renewing primary care
Type: Journal Article
Year: 2008
Publication Place: United States
Topic(s):
Medical Home
See topic collection
406
Patient-centered medical homes: presenting a role for the advanced practice mental health nurse
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Medical Home
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Reference Links:
View the DOI record for Patient-centered medical homes: presenting a role for the advanced practice mental health nurse
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View the PubMed citation for Patient-centered medical homes: presenting a role for the advanced practice mental health nurse410
Patients use the internet to enter the medical home
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: There is a large gap between the promise of patient-centered medical home (PCMH) and our current capacity to define and measure it. The purpose of this article is to describe the findings of "real-time" patient-reported data about constructs of the PCMH and to demonstrate how an Internet-based method can be useful for obtaining patient report about the PCMH. We find that patients' Internet ratings seem stable and demonstrate relationships that fit constructs and models for the PCMH. We also find that current PCMH performance across this sample of 69 clinical settings is highly variable and still leaves a great deal of room for improvement.
Topic(s):
Medical Home
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412
Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care
Type: Journal Article
Year: 2017
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Medical Home
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Reference Links:
View the DOI record for Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care
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View the PubMed citation for Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care413
Pediatric medical home: Foundations, challenges, and future directions
Type: Journal Article
Year: 2011
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 Pediatric medical home: Foundations, challenges, and future directions
414
Pediatric mental health emergencies in the emergency medical services system
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: Emergency departments are vital in the management of pediatric patients with mental health emergencies. Pediatric mental health emergencies are an increasing part of emergency medical practice because emergency departments have become the safety net for a fragmented mental health infrastructure that is experiencing critical shortages in services in all sectors. Emergency departments must safely, humanely, and in a culturally and developmentally appropriate manner manage pediatric patients with undiagnosed and known mental illnesses, including those with mental retardation, autistic spectrum disorders, and attention-deficit/hyperactivity disorder and those experiencing a behavioral crisis. Emergency departments also manage patients with suicidal ideation, depression, escalating aggression, substance abuse, posttraumatic stress disorder, and maltreatment and those exposed to violence and unexpected deaths. Emergency departments must address not only the physical but also the mental health needs of patients during and after mass-casualty incidents and disasters. The American Academy of Pediatrics and the American College of Emergency Physicians support advocacy for increased mental health resources, including improved pediatric mental health tools for the emergency department, increased mental health insurance coverage, and adequate reimbursement at all levels; acknowledgment of the importance of the child's medical home; and promotion of education and research for mental health emergencies.
Topic(s):
Medical Home
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Reference Links: View the PubMed citation for Pediatric mental health emergencies in the emergency medical services system
415
Pennsylvania's Medical Home Initiative: Reductions in Healthcare Utilization and Cost Among Medicaid Patients with Medicaland Psychiatric Comorbidities
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: BACKGROUND: The Chronic Care Initiative (CCI) was a large state-wide patient-centered medical home (PCMH) initiative in Pennsylvania in place from 2008-2011. OBJECTIVE: Determine whether the CCI impacted the utilization and costs for Medicaid patients with chronic medical conditions and comorbid psychiatric or substance use disorders. DESIGN: Analysis of Medicaid claims using difference-in-difference regression analyses to compare changes in utilization and costs for patients treated at CCI practices to propensity score-matched patients treated at comparison non-CCI practices. SETTING: Ninety-six CCI practices in Pennsylvania and 60 non-CCI practices during the same time period. PARTICIPANTS: A total of 11,105 comorbid Medicaid patients treated in CCI practices and an equal number of propensity-matched comparison patients treated in non-CCI practices. MEASUREMENTS: Changes in total per-patient costs from 1 year prior to 1 year following an index episode period. Secondary outcomes included utilization and costs for emergency department (ED), inpatient, and outpatient services. RESULTS: The CCI group experienced an average adjusted total cost savings of $4145.28 per patient per year (P = 0.023) for the CCI relative to the non-CCI group. This was largely driven by a $3521.15 savings (P = 0.046) in inpatient medical costs, in addition to relative savings in outpatient psychiatric ($21.54, P < 0.001) and substance abuse service costs ($16.42, P = 0.013), compared to the non-CCI group. The CCI group, related to the non-CCI group, had decreases in expected mean counts of ED visits (for those who had any) and psychiatric hospitalizations of 15.6 (95 % CI: -21, -9) and 40.7 (95 % CI: -57, -18) percentage points respectively. LIMITATIONS: We do not measure quality of care and cannot make conclusions about the overall cost-effectiveness or long-term effects of the CCI. CONCLUSIONS: The CCI was associated with substantial cost savings, attributable primarily to reduced inpatient costs, among a high-risk group of Medicaid patients, who may disproportionally benefit from care management in patient-centered medical homes.
Topic(s):
Financing & Sustainability
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, Medical Home
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416
Performance enhancement using a balanced scorecard in a Patient-centered Medical Home
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: BACKGROUND AND OBJECTIVES: Oregon Health & Science University Family Medicine implemented a balanced scorecard within our clinics that embraces the inherent tensions between care quality, financial productivity, and operational efficiency. This data-driven performance improvement process involved: (1) consensus-building around specific indicators to be measured, (2) developing and refining the balanced scorecard, and (3) using the balanced scorecard in the quality improvement process. Developing and implementing the balanced scorecard stimulated an important culture shift among clinics; practice members now actively use data to recognize successes, understand emerging problems, and make changes in response to these problems. Our experience shows how Patient-centered Medical Homes can be enhanced through use of information technology and evidence-based tools that support improved decision making and performance and help practices develop into learning organizations.
Topic(s):
HIT & Telehealth
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, Medical Home
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Reference Links: View the PubMed citation for Performance enhancement using a balanced scorecard in a Patient-centered Medical Home
417
Pharmacist integration into the medical home: Qualitative analysis
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: OBJECTIVE: To determine the acceptance and attitudes of family medicine physicians, clinical and nonclinical office staff, pharmacists, and patients during pharmacist integration into a medical home. DESIGN: Qualitative study.Setting: Pittsburgh, PA, area from August 2009 to June 2010. PARTICIPANTS: Physicians, staff, pharmacists, and patients at four single-specialty family medicine office practices functioning as medical homes. MAIN OUTCOME MEASURES: Attitudes, acceptance, barriers, and problems identified by participants. RESULTS: A total of 84 interviews were conducted: 21 interviews with family medicine physicians, 26 with patient care staff, 9 with nonclinical staff, 13 with patients, 6 with pharmacists, and 8 with office managers. Five main themes emerged from each group regarding the integration of a pharmacist, including positive overall feeling; clinical, educational, and time-saving benefits to the various groups; challenges understanding the role of the pharmacist; improved workflow and integration resulting from pharmacist flexibility and motivation; and suggestions to increase the pharmacists' time in each office. Pharmacists felt that they were accepted within 6 months of the integration process and that time management was a challenge. CONCLUSION: Participants felt that inclusion of a pharmacist into their practice improves the quality of patient care, provides a valuable resource for all providers and staff, and empowers patients. The initial concerns of the clinical and nonclinical staff disappeared within the first months of pharmacist integration. These results provide guidance to clinicians and insight into strategies for building a pharmacist-integrated medical home team.
Topic(s):
Education & Workforce
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, Medical Home
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Reference Links:
View the DOI record for Pharmacist integration into the medical home: Qualitative analysis
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View the PubMed citation for Pharmacist integration into the medical home: Qualitative analysis418
Pharmacist-provided services and community pharmacist integration into a patient-centered medical home: A qualitative study of primary care clinic staff perceptions
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Medical Home
See topic collection
419
Physical health outcomes and implementation of behavioural health homes: a comprehensive review
Type: Journal Article
Year: 2018
Publication Place: England
Abstract: People with serious mental illness (SMI) have mortality rates 2-3-times higher than the general population, mostly driven by physical health conditions. Behavioural health homes (BHHs) integrate primary care into specialty mental healthcare settings with the goal of improving management of physical health conditions among people with SMI. Implementation and evaluation of BHH models is increasing in the US. This comprehensive review summarized the available evidence on the effects of BHHs on physical healthcare delivery and outcomes and identified perceived barriers and facilitators that have arisen during implementation to-date. This review found 11 studies reporting outcomes data on utilization, screening/monitoring, health promotion, patient-reported outcomes, physical health and/or costs of BHHs. The results of the review suggest that BHHs have resulted in improved primary care access and screening and monitoring for cardiovascular-related conditions among consumers with SMI. No significant effect of BHHs was reported for outcomes on diabetes control, weight management, or smoking cessation. Overall, the physical health outcomes data is limited and mixed, and implementation of BHHs is variable.
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Disparities
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, Medical Home
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Reference Links:
View the DOI record for Physical health outcomes and implementation of behavioural health homes: a comprehensive review
View DOI Record
View the PubMed citation for Physical health outcomes and implementation of behavioural health homes: a comprehensive review