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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).
11199 Results
3204
Does primary care mental health resourcing affect the use and costs of secondary psychiatric services?
Type: Journal Article
Year: 2014
Publication Place: Switzerland
Abstract: Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration.
Topic(s):
Financing & Sustainability
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Reference Links: 
View the DOI record for Does primary care mental health resourcing affect the use and costs of secondary psychiatric services?
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View the PubMed citation for Does primary care mental health resourcing affect the use and costs of secondary psychiatric services?3205
Does race make a difference among primary care patients with alcohol problems who agree to enroll in a study of brief interventions?
Type: Journal Article
Year: 2000
Publication Place: United States
Abstract: This study describes the severity, alcohol consumption, consequences, readiness to change, and coping behaviors of African-American and white primary care patients enrolled in a trial of brief interventions for problem drinking. In multivariate analysis, unemployment but not race was associated with clinical indicators of alcohol problems. African-Americans reported no difference in alcohol consumption and similar quality of life scores. African-American race and unemployment were both associated with increased identification and resolution of alcohol problems. There was no difference in readiness to change, but African-Americans reported more problems related to alcohol and greater use of coping behaviors to avoid drinking. African-Americans may be better equipped to manage drinking problems when they do occur due to increased familiarity with coping mechanisms.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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3207
Does screening for depression in primary care improve outcome?
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: 2012 marks one decade since the US Preventive Services Task Force recommended screening for depression. Advances since then include expanded understanding of the mechanisms underlying and influences of psychiatric disease on the development, course and outcomes of medical conditions. They also include collaborative care strategies to improve outcomes. However, the impact of such single disease approaches has been disappointing. Strategies that integrate management of multiple morbidities into primary care practice have greatly improved outcomes. Depression has been the only psychiatric condition incorporated into these strategies. Their expansion to integrate recognition and care of bipolar disease, anxiety disorders including PTSD, and substance abuse could further improve outcomes with modest marginal cost. Development of a screening and treatment monitoring instrument for multiple common psychiatric conditions is a prerequisite. One recently developed instrument, the M3, has the performance characteristics desirable, and provides opportunity to incorporate multiple common psychiatric conditions into multimorbidity integrated management.
Topic(s):
Measures
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, Healthcare Disparities
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Reference Links:
View the DOI record for Does screening for depression in primary care improve outcome?
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View the PubMed citation for Does screening for depression in primary care improve outcome?3210
Does shared care help in the treatment of depression?
Type: Journal Article
Year: 2010
Publication Place: Croatia
Abstract: INTRODUCTION: shared or Collaborative Care in the treatment of Depression is an evidence based intervention which has been shown to be more effective than ordinary general Practitioner care in the treatment of Depression, however, it is not yet Government policy in the United Kingdom. We aimed to bring together in one place all the studies which have been carried out, up till mid 2009, in order to demonstrate the evidence that shared collaborative care has important advantages in terms both of depression outcomes and cost benefits, in order to argue for the adoption of this approach in the United Kingdom and n Europe. METHODS: we carried out a literature search using PUBMED in order to identify and describe all trials, systematic reviews and Metanalyses which have been carried out on shared care until mid 2009. We also described a shared care service for depression which some of us had been involved in developing and working in in Luton in the late 1990's. We have excluded papers which describe trials which have not yet been carried out, and instead focussed on the trials which have reported. RESULTS: it has been demonstrated in numerous recent studies that shared care in the treatment of depression, which includes the training of General Practitoners in the treatment of depression, and the provision in Primary Care of a Nurse specialist or another professional who will impart psycho-education, ensure concordance with medication, and may provide psychotherapy, leads to both improved treatment outcomes and increased doctor and patient satisfaction, as well providing some cost-benefits, despite somewhat increased immediate costs. This is the case in both adult and adolescent patients, while in the case of diabetic patients depression is improved, despite the lack of improvement in glycaemic control. The shared care intervention continues to be useful in the case of patients with resistant depressive symptoms, though a longer input will be necessary in such cases. Patients with subthreshold depression will not benefit as much, and patients expressed more satisfaction when psychological interventions were offered. It is also the case that collaborative or shared care is effective in treating depression in the elderly. This is shown by studies which include older patients who also suffer from multiple health conditions, arthritis, diabetes, anxiety and PTSD, the poorer, those with suicidal ideation, and also in Ethnic Minorities. DISCUSSION: The results described above are mostly based on studies carried out in the USA, but similar studies have been reported from the United Kingdom, and are consistent with the experience of the service in Luton which we describe. From these results it would seem important that shared, collaborative care, with primary and secondary care doctors (General Practitioners and Psychiatrists) working as part of a single team, with the help of mental health practitioners attached to primary care, but with easy access to secondary care is a productive way of optimising the treatment of depression. In the UK, however, it has not yet been possible to develop such a service for the whole population. This is becausein the UK, General Practice is managed by Primary Care Trusts, while Secondary Care, including Psychiatry, is managed by Mental Health Trusts. This has led the National Institute of Health and Clinical Excellence, and indeed local commissioners of care to focus on a Stepped Model for the treatment of depression, with one key issue being access (or referral) to secondary care, and discharge back to primary care, with a group of Mental Health workers focussing on the facilitation (or gate-keeping) of these processes, rather than focussing on actually optimising outcomes of care. CONCLUSION: the evidence argues for the development of collaborative care between primary and secondary care for the treatment of Depression. This will require common medication guidelines across both Primary and Secondary Care, easy access so that General Practitioners can receive advice from Psychiatrists about patients, and the use of Mental Health Professionals to provide patients with psycho-education, support of concordance with treatment, and psychotherapy. It may be that, in order for this to be achieved, services may need to be re-structured, to allow easy communication between professionals.
Topic(s):
Financing & Sustainability
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, Healthcare Policy
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3212
Does symptom severity matter in stepped and collaborative care for depression?
Type: Journal Article
Year: 2020
Publication Place: Netherlands
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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, Measures
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Reference Links:
View the DOI record for Does symptom severity matter in stepped and collaborative care for depression?
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View the PubMed citation for Does symptom severity matter in stepped and collaborative care for depression?3213
Does teaching an entire nursing degree rurally have more workforce impact than rural placements?
Type: Journal Article
Year: 2010
Publication Place: Australia
Abstract: Education plays a key role in recruitment of health workforce to rural and remote locations. In Australia, Schools of Nursing have set up a variety of educational programmes to encourage rural workforce choices. These programmes include rural campuses and short-term rural placement programmes out of urban campuses. This study compares the relative workforce impacts of rural campus versus short-term rural placements out of urban campus. The single outcome measure - rural or urban location after graduation - showed that the rural school graduated a significantly higher proportion of rural-working graduates (chi(2) 4.46, p = 0.04). However there was no difference in the rural workforce choices of students from rural backgrounds, irrespective of their university location (chi(2) = 1.45, p = 0.23). We conclude that both rural universities and affirmative action for selecting rural students into nursing programmes are effective workforce strategies, but that rural campuses have the added benefit of encouraging under-represented rural students to access university education.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links:
View the DOI record for Does teaching an entire nursing degree rurally have more workforce impact than rural placements?
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View the PubMed citation for Does teaching an entire nursing degree rurally have more workforce impact than rural placements?3215
Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: BACKGROUND: Few studies have looked under the hood of practice redesign to understand whether and, if so, how staffing changed with the adoption of patient-centered medical home (PCMH), and whether these staffing changes impacted utilization. OBJECTIVES: To examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits. RESEARCH DESIGN, SUBJECTS, MEASURES: Using a difference-in-differences approach, we compared staffing and utilization outcomes in 450 community health centers that had adopted a PCMH model between 2007 and 2013 to a matched sample of 243 nonadopters located in the 50 states and the District of Columbia. RESULTS: We found that adopting a PCMH model was significantly associated with a growth in use of advanced practice staff (nurse practitioners and physician assistants) [0.53 full-time equivalent (FTE), 8.77%; P<0.001], other medical staff (medical assistants, nurse aides, and quality assurance staff) (1.23 FTE, 7.46%; P=0.001), mental health/substance abuse staff (0.73 FTE, 17.63%; P=0.005), and enabling service staff (case managers and health educators) (0.36 FTE, 6.14%; P=0.079), but not primary care physicians or nurses. We did not observe a significant increase in utilization, as measured in total number of visits per year. However, the visits marginally attributed to advanced practice staff (539 FTE, 0.89%; P=0.037) and mental health/substance abuse staff (353 FTE, 0.59%; P=0.051) significantly increased. CONCLUSIONS: Our findings suggest that the implementation of PCMH actively reengineers staff composition and this, in turn, results in changes in marginal utilization by each staff type.
Topic(s):
Financing & Sustainability
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, Medical Home
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Reference Links:
View the DOI record for Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
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View the PubMed citation for Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?3216
Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: BACKGROUND: Few studies have looked under the hood of practice redesign to understand whether and, if so, how staffing changed with the adoption of patient-centered medical home (PCMH), and whether these staffing changes impacted utilization. OBJECTIVES: To examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits. RESEARCH DESIGN, SUBJECTS, MEASURES: Using a difference-in-differences approach, we compared staffing and utilization outcomes in 450 community health centers that had adopted a PCMH model between 2007 and 2013 to a matched sample of 243 nonadopters located in the 50 states and the District of Columbia. RESULTS: We found that adopting a PCMH model was significantly associated with a growth in use of advanced practice staff (nurse practitioners and physician assistants) [0.53 full-time equivalent (FTE), 8.77%; P<0.001], other medical staff (medical assistants, nurse aides, and quality assurance staff) (1.23 FTE, 7.46%; P=0.001), mental health/substance abuse staff (0.73 FTE, 17.63%; P=0.005), and enabling service staff (case managers and health educators) (0.36 FTE, 6.14%; P=0.079), but not primary care physicians or nurses. We did not observe a significant increase in utilization, as measured in total number of visits per year. However, the visits marginally attributed to advanced practice staff (539 FTE, 0.89%; P=0.037) and mental health/substance abuse staff (353 FTE, 0.59%; P=0.051) significantly increased. CONCLUSIONS: Our findings suggest that the implementation of PCMH actively reengineers staff composition and this, in turn, results in changes in marginal utilization by each staff type.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
View DOI Record
View the PubMed citation for Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?3218
Does the Primary Care Behavioral Health Model Reduce Emergency Department Visits?
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for Does the Primary Care Behavioral Health Model Reduce Emergency Department Visits?
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View the PubMed citation for Does the Primary Care Behavioral Health Model Reduce Emergency Department Visits?3219
Does training in motivational interviewing for community pharmacists improve outcomes for methadone patients? A cluster randomised controlled trial
Type: Journal Article
Year: 2014
Publication Place: England
Topic(s):
Opioids & Substance Use
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, Education & Workforce
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