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Opioids & SU
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).
614 Results
1
"A PCMH mind and a PCMH heart": Patient, faculty, and learner perspectives on collaborative care in an interprofessional team-based training programme
Type: Journal Article
Year: 2020
Publication Place: England
Topic(s):
Education & Workforce
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, Medical Home
See topic collection
4
"It goes beyond good camaraderie": A qualitative study of the process of becoming an interprofessional healthcare "teamlet"
Type: Journal Article
Year: 2016
Publication Place: Abingdon
Topic(s):
Education & Workforce
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, Medical Home
See topic collection
6
A case series of buprenorphine/naloxone treatment in a primary care practice
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: Physicians' adoption of buprenorphine/naloxone treatment is hindered by concerns over feasibility, cost, and lack of comfort treating patients with addiction. We examined the use of buprenorphine/naloxone in a community practice by two generalist physicians without addiction training, employing a retrospective chart review. From 2006-2010, 228 patients with opiate abuse/dependence were treated with buprenorphine/naloxone using a home-induction protocol. Multiple co-morbidities including diabetes (23% of patients), hypertension (36%), Hepatitis C (43%), and depression (74%) were concurrently managed. In this diverse sample, 1/228 experienced precipitated withdrawal during induction. Of the convenience subsample analyzed (n = 28), 82% (+/-10%) had negative urine drug tests for opioids; 92% (+/-11%) were negative for cocaine; 88% (+/-12%) were positive for buprenorphine. This case series demonstrated feasibility and safety of a low-cost buprenorphine/naloxone home induction protocol employed by generalists. Concurrent treatment of multiple comorbidities conforms with the patient-centered medical home ideal. Randomized trials of this promising approach are needed.
Topic(s):
Opioids & Substance Use
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, Medical Home
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Reference Links: 
View the DOI record for A case series of buprenorphine/naloxone treatment in a primary care practice
View DOI Record
View the PubMed citation for A case series of buprenorphine/naloxone treatment in a primary care practice8
A clustered controlled trial of the implementation and effectiveness of a medical home to improve health care of people with serious mental illness: study protocol
Type: Journal Article
Year: 2018
Publication Place: England
Topic(s):
Healthcare Disparities
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, Medical Home
See topic collection
9
A comparison of assertive community treatment fidelity measures and patient-centered medical home standards
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: OBJECTIVE This study compared program measures of assertive community treatment (ACT) with standards of accreditation for the patient-centered medical home (PCMH) to determine whether there were similarities in the infrastructure of the two methods of service delivery and whether high-fidelity ACT teams would qualify for medical home accreditation. METHODS The authors compared National Committee for Quality Assurance PCMH standards with two ACT fidelity measures (the Dartmouth Assertive Community Treatment Scale and the Tool for Measurement of Assertive Community Treatment [TMACT]) and with national ACT program standards. RESULTS PCMH standards pertaining to enhanced access and continuity, management of care, and self-care support demonstrated strong overlap across ACT measures. Standards for identification and management of populations, care coordination and follow-up, and quality improvement demonstrated less overlap. The TMACT and the program standards had sufficient overlap to score in the range of a level 1 PCMH, but no ACT measure sufficiently detailed methods of population-based screening and tracking of referrals to satisfy "must-pass" elements of the standards. CONCLUSIONS ACT measures and medical home standards had significant overlap in innate infrastructure. ACT teams following the program standards or undergoing TMACT fidelity review could have the necessary infrastructure to serve as medical homes if they were properly equipped to supervise general medical care and administer activities to improve management of chronic diseases.
Topic(s):
Measures
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, Medical Home
See topic collection
Reference Links:
View the DOI record for A comparison of assertive community treatment fidelity measures and patient-centered medical home standards
View DOI Record
View the PubMed citation for A comparison of assertive community treatment fidelity measures and patient-centered medical home standards11
A comparison of Tier 1 and Tier 3 medical homes under Oklahoma Medicaid program
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: INTRODUCTION: The patient-centered medical home (PCMH) is a team-based model of care that seeks to improve quality of care and control costs. The Oklahoma Health Care Authority (OHCA) directs Oklahoma's Medicaid program and contracts with 861 medical home practices across the state in one of three tiers of operational capacity: Tier 1 (Basic), Tier 2 (Advanced) and Tier 3 (Optimal). Only 13.5% (n = 116) homes are at the optimal level; the majority (59%, n = 508) at the basic level. In this study, we sought to determine the barriers that prevented Tier 1 homes from advancing to Tier 3 level and the incentives that would motivate providers to advance from Tier 1 to 3. Our hypotheses were that Tier 1 medical homes were located in smaller practices with limited resources and the providers are not convinced that the expense of advancing from Tier 1 status to Tier 3 status was worth the added value. METHODS: We analyzed OHCA records to compare the 508 Tier 1 (entry-level) with 116 Tier 3 (optimal) medical homes for demographic differences with regards to location: urban or rural, duration as medical home, percentage of contracts that were group contracts, number of providers per group contract, panel age range, panel size, and member-provider ratio. We surveyed all 508 Tier 1 homes with a mail-in survey, and with focused follow up visits to identify the barriers to, and incentives for, upgrading from Tier 1 to Tier 2 or 3. RESULTS: We found that Tier 1 homes were more likely to be in rural areas, run by solo practitioners, serve exclusively adult panels, have smaller panel sizes, and have higher member-to-provider ratios in comparison with Tier 3 homes. Our survey had a 35% response rate. Results showed that the most difficult changes for Tier 1 homes to implement were providing 4 hours of after-hours care and a dedicated program for mental illness and substance abuse. The results also showed that the most compelling incentives for encouraging Tier 1 homes to upgrade their tier status were less"red tape"with prior authorizations, higher pay, and help with panel member follow-up. DISCUSSION: Multiple interventions may help medical homes in Oklahoma advance from the basic to the optimal level such as sharing of resources among nearby practices, expansion of OHCA online resources to help with preauthorizations and patient follow up, and the generation and transmission of data on the benefits of medical homes.
Topic(s):
Medical Home
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, Healthcare Disparities
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, Healthcare Policy
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Reference Links: View the PubMed citation for A comparison of Tier 1 and Tier 3 medical homes under Oklahoma Medicaid program
13
A Difference-in-Difference Analysis of Changes in Quality, Utilization and Cost Following the Colorado Multi-Payer Patient-Centered Medical Home Pilot
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: BACKGROUND: Research on the effects of patient-centered medical homes on quality and cost of care is mixed, so further study is needed to understand how and in what contexts they are effective. OBJECTIVE: We aimed to evaluate effects of a multi-payer pilot promoting patient-centered medical home implementation in 15 small and medium-sized primary care groups in Colorado. DESIGN: We conducted difference-in-difference analyses, comparing changes in utilization, costs, and quality between patients attributed to pilot and non-pilot practices. PARTICIPANTS: Approximately 98,000 patients attributed to 15 pilot and 66 comparison practices 2 years before and 3 years after the pilot launch. MAIN MEASURES: Healthcare Effectiveness Data and Information Set (HEDIS) derived measures of diabetes care, cancer screening, utilization, and costs to payers. KEY RESULTS: At the end of two years, we found a statistically significant reduction in emergency department use by 1.4 visits per 1000 member months, or approximately 7.9 % (p = 0.02). At the end of three years, pilot practices sustained this difference with 1.6 fewer emergency department visits per 1000 member months, or a 9.3 % reduction from baseline (p = 0.01). Emergency department costs were lower in the pilot practices after two (13.9 % reduction, p < 0.001) and three years (11.8 % reduction, p = 0.001). After three years, compared to control practices, primary care visits in the pilot practices decreased significantly (1.5 % reduction, p = 0.02). The pilot was associated with increased cervical cancer screening after two (12.5 % increase, p < 0.001) and three years (9.0 % increase, p < 0.001), but lower rates of HbA1c testing in patients with diabetes (0.7 % reduction at three years, p = 0.03) and colon cancer screening (21.1 % and 18.1 % at two and three years, respectively, p < 0.001). For patients with two or more comorbidities, similar patterns of association were found, except that there was also a reduction in ambulatory care sensitive inpatient admissions (10.3 %; p = 0.05). CONCLUSION: Our findings suggest that a multi-payer, patient-centered medical home initiative that provides financial and technical support to participating practices can produce sustained reductions in utilization with mixed results on process measures of quality.
Topic(s):
Financing & Sustainability
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, Medical Home
See topic collection
14
A logic framework for evaluating social determinants of health interventions in primary care
Type: Journal Article
Year: 2019
Publication Place: China
Abstract: Background: Increasing efforts have been made in primary care settings to screen for a broad array of social determinants of health including inadequate food and nutrition, lack of education, unemployment, and inadequate housing, and to refer patients to community resources. Core tenets of primary care include integration with community resources. Methods: In the course of designing a randomized controlled trial of the effectiveness of a social determinants of health intervention aimed at adult, at-risk, African American primary care clinic patients, our research team developed a logic model to assist with the evaluation of the intervention. Results: In this article, we describe the logic model including elements of the intervention, mediator variables, and outcome variables. Conclusions: The proposed logic framework is likely to be helpful for planning, conducting, and evaluating social determinants of health interventions in primary care settings.
Topic(s):
Healthcare Disparities
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, Medical Home
See topic collection
Reference Links: View the PubMed citation for A logic framework for evaluating social determinants of health interventions in primary care
15
A logic framework for evaluating social determinants of health interventions in primary care
Type: Journal Article
Year: 2019
Publication Place: China
Abstract: Background: Increasing efforts have been made in primary care settings to screen for a broad array of social determinants of health including inadequate food and nutrition, lack of education, unemployment, and inadequate housing, and to refer patients to community resources. Core tenets of primary care include integration with community resources. Methods: In the course of designing a randomized controlled trial of the effectiveness of a social determinants of health intervention aimed at adult, at-risk, African American primary care clinic patients, our research team developed a logic model to assist with the evaluation of the intervention. Results: In this article, we describe the logic model including elements of the intervention, mediator variables, and outcome variables. Conclusions: The proposed logic framework is likely to be helpful for planning, conducting, and evaluating social determinants of health interventions in primary care settings.
Topic(s):
Healthcare Disparities
See topic collection
, Medical Home
See topic collection
Reference Links: View the PubMed citation for A logic framework for evaluating social determinants of health interventions in primary care
18
A meta-analysis of the efficacy of nonphysician brief interventions for unhealthy alcohol use: Implications for the Patient-Centered Medical Home
Type: Journal Article
Year: 2011
Publication Place: England
Topic(s):
Medical Home
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19
A national and state profile of leading health problems and health care quality for US children: Key insurance disparities and across-state variations
Type: Journal Article
Year: 2011
Publication Place: United States
Topic(s):
Medical Home
See topic collection