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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).
11272 Results
3321
Economic Evaluation: A Randomized Pragmatic Trial of a Primary Care-based Cognitive Behavioral Intervention for Adults Receiving Long-term Opioids for Chronic Pain
Type: Journal Article
Year: 2022
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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, Opioids & Substance Use
See topic collection
3324
Economic impact of personality disorders in UK primary care attenders
Type: Journal Article
Year: 2002
Publication Place: England
Abstract: BACKGROUND: The economic impact of personality disorders on UK health services is unknown. AIMS: To test the hypothesis that people with personality disorders have higher mean health and non-health costs compared with those without personality disorders. METHOD: Prospective cohort study design. A total of 303 general practice attenders were followed-up I year after they had been assessed for the presence of personality disorders. Costs were estimated in pound sterling at 1999 price levels. RESULTS: The mean total cost for patients with personality disorders was pound sterling 3094 (s.d.=5324) compared with pound sterling 1633 (s.d.=3779) for those without personality disorders. Personality disorders were not independently associated with increased costs. Multivariate analyses identified the presence of a significant interaction between personality disorders and common mental disorders and increased total costs (coefficient=499, 95% CI 180.1-626.2, P=0.002). CONCLUSIONS: Personality disorders are not independently associated with increased costs. An interaction between personality disorders and common mental disorders significantly predicts increased total costs.
Topic(s):
Financing & Sustainability
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Reference Links: View the PubMed citation for Economic impact of personality disorders in UK primary care attenders
3325
Economic implications of shared care arrangements. A primary care based study of patients in an inner city sample
Type: Journal Article
Year: 2004
Publication Place: Germany
Abstract: BACKGROUND: Providing care for people with serious and enduring mental health problems has been prioritised in a number of countries. It has been recognised that good liaison between primary and secondary care services is required for care to be effective. However, little is known about the resource implications of different levels of 'shared care'. The aim of this study is to compare service use and costs of different levels of shared care between primary and secondary care services. METHOD: Service use data were collected at baseline and one year later for participants with severe mental illness and costs were calculated. Levels of shared care were categorised into low, medium and high tertiles. Comparisons were made between the groups using multivariate analysis to control for participant characteristics. RESULTS: Participants receiving a low level of shared care used residential care less and were less likely to have contacts with a psychiatrist or social worker than those receiving medium or high levels of shared care. Mean costs for a low level of shared care were significantly lower than for a medium level (a difference of pound 2606, 90% CI pound 452 to pound 4923), but not significantly lower than for a high level of shared care (difference of pound 1867, 90% CI- pound 287 to pound 3903). CONCLUSION: Different levels of shared care are associated with different patterns of service use, with greater resource consumption associated with a medium level of shared care. Further work is required to investigate the causal links between integrated care and service use and costs.
Topic(s):
Financing & Sustainability
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Reference Links:
View the DOI record for Economic implications of shared care arrangements. A primary care based study of patients in an inner city sample
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View the PubMed citation for Economic implications of shared care arrangements. A primary care based study of patients in an inner city sample3328
Economics of collaborative care for management of depressive disorders: a community guide systematic review
Type: Journal Article
Year: 2012
Publication Place: Netherlands
Abstract: CONTEXT: Major depressive disorders are frequently underdiagnosed and undertreated. Collaborative Care models developed from the Chronic Care Model during the past 20 years have improved the quality of depression management in the community, raising intervention cost incrementally above usual care. This paper assesses the economic efficiency of collaborative care for management of depressive disorders by comparing its economic costs and economic benefits to usual care, as informed by a systematic review of the literature. EVIDENCE ACQUISITION: The economic review of collaborative care for management of depressive disorders was conducted in tandem with a review of effectiveness, under the guidance of the Community Preventive Services Task Force, a nonfederal, independent group of public health leaders and experts. Economic review methods developed by the Guide to Community Preventive Services were used by two economists to screen, abstract, adjust, and summarize the economic evidence of collaborative care from societal and other perspectives. An earlier economic review that included eight RCTs was included as part of the evidence. The present economic review expanded the evidence with results from studies published from 1980 to 2009 and included both RCTs and other study designs. EVIDENCE SYNTHESIS: In addition to the eight RCTs included in the earlier review, 22 more studies of collaborative care that provided estimates for economic outcomes were identified, 20 of which were evaluations of actual interventions and two of which were based on models. Of seven studies that measured only economic benefits of collaborative care in terms of averted healthcare or productivity loss, four found positive economic benefits due to intervention and three found minimal or no incremental benefit. Of five studies that measured both benefits and costs, three found lower collaborative care cost because of reduced healthcare utilization or enhanced productivity, and one found the same for a subpopulation of the intervention group. One study found that willingness to pay for collaborative care exceeded program costs. Among six cost-utility studies, five found collaborative care was cost effective. In two modeled studies, one showed cost effectiveness based on comparison of $/disability-adjusted life-year to annual per capita income; the other demonstrated cost effectiveness based on the standard threshold of $50,000/quality-adjusted life year, unadjusted for inflation. Finally, six of eight studies in the earlier review reported that interventions were cost effective on the basis of the standard threshold. CONCLUSIONS: The evidence indicates that collaborative care for management of depressive disorders provides good economic value.
Topic(s):
Financing & Sustainability
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Reference Links:
View the DOI record for Economics of collaborative care for management of depressive disorders: a community guide systematic review
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View the PubMed citation for Economics of collaborative care for management of depressive disorders: a community guide systematic review3329
eConsult Mental Health: Electronic Referral and Consultation to Integrate Primary Care and Mental Health
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
HIT & Telehealth
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, Medical Home
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Reference Links:
View the DOI record for eConsult Mental Health: Electronic Referral and Consultation to Integrate Primary Care and Mental Health
View DOI Record
View the PubMed citation for eConsult Mental Health: Electronic Referral and Consultation to Integrate Primary Care and Mental Health3330
eDiagnostics: a promising step towards primary mental health care
Type: Journal Article
Year: 2013
Publication Place: England
Abstract: INTRODUCTION: There is a growing interest in eHealth applications in daily health care. Considering that a psychological examination, to a large extent, consists of filling out questionnaires, the use of the Internet seems logical. We evaluated an eDiagnostic system for mental health disorders that has recently been introduced in primary care in the Netherlands. METHODS: We monitored the diagnoses produced by the system. Evaluation questionnaires from both GPs/practice nurses (PNs) and patients were collected. In addition, we compared the advice produced by the GPs/PNs and the advice produced by the system. RESULTS: The most prevalent disorders were mood, anxiety and somatoform disorders (n = 353). Patients (n = 242; 74% response rate) were moderately enthusiastic about the eHealth approach, and GPs/PNs (n = 49, 72% response rate per practice) were very enthusiastic. Patients showed no clear preference for a face-to-face consultation with a psychologist over an eDiagnostic system. GPs/PNs felt strengthened in their control function. In most cases, the system gave a different echelon advice (i.e. referral to primary or secondary mental health care) than the GPs/PNs (kappa = 0.13, P = 0.003). Nevertheless, GPs/PNs accept the results of the examination and the advice given. CONCLUSIONS: Using the Internet to diagnose mental health problems in primary care seems very promising. This system of using eDiagnostics before referral to a mental health institution may change the management of mental health care. Further research should investigate whether this tool is valid, reliable and (cost) effective.
Topic(s):
HIT & Telehealth
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, Medically Unexplained Symptoms
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Reference Links:
View the DOI record for eDiagnostics: a promising step towards primary mental health care
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View the PubMed citation for eDiagnostics: a promising step towards primary mental health care3333
Editors' introduction: The evidence for integrated care-substance use disorders, mental health and primary care: California Substance Abuse Research Consortium (SARC) meetings, 2011
Type: Journal Article
Year: 2012
Publication Place: United States
Topic(s):
Opioids & Substance Use
See topic collection
3335
Educating health professionals collaboratively for team-based primary care
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: Team-based primary care offers the potential to dramatically improve the quality and efficiency of care, but its broader adoption is hindered by an education system that trains health professions in silos. Collaborative models that educate multiple practitioners together are needed to create a new generation of health professionals able to work in efficiently functioning teams. Changes in professional cultures, organizational structures, clinical partnerships, admissions, accreditation, and funding models will be required to support the expansion of collaborative education effectively.
Topic(s):
Education & Workforce
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, Medical Home
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Reference Links:
View the DOI record for Educating health professionals collaboratively for team-based primary care
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View the PubMed citation for Educating health professionals collaboratively for team-based primary care3339
Educating primary care physicians in the management of Alzheimer's disease: Using practice guidelines to set quality benchmarks
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: This paper presents a strategy for training primary care physicians in the identification, diagnosis and management of Alzheimer's disease and related disorders. The strategy uses evidence-based practice guidelines to establish quality benchmarks and then provides training and other interventions to improve the quality of care received by these patients. The three projects described in this paper assumed that training of primary care physicians alone would not be sufficient to achieve the quality benchmarks derived from guidelines. The projects used creative training strategies supplemented by provider "tool kits", provider checklists, educational detailing, and endorsement from organizational leadership to reinforce what the primary care providers learned in educational sessions. Each project also implemented a system of dementia care management to "wrap around" traditional primary care to ensure that quality benchmarks would be achieved. Outcomes of two completed studies support the premise that it is possible to improve quality of dementia care through physician education that occurs in association with a coordinated system of dementia care management and in collaboration with community agencies to access guideline-recommended social services.
Topic(s):
Education & Workforce
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3340
Educating residents in behavioral health care and collaboration: Comparison of conventional and integrated training models
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: PURPOSE: To determine whether former pediatric residents trained using a model of integrated behavioral health (BH) care in their primary care continuity clinics felt more comfortable managing BH care and better prepared to collaborate with BH professionals than did peers from the same residency who trained in clinics with a conventional model of BH care. METHOD: University of Rochester School of Medicine and Dentistry pediatric residents were assigned to one of two continuity clinic sites. At one site, psychology fellows and faculty were integrated into the clinic teams in the mid-1990s. At the other, conventional patterns of consultation and referral continued. In 2004, the authors surveyed 245 alumni (graduated 1989-2003) about their experiences and their comfort with providing BH care and collaborating with BH providers in their current practice. RESULTS: A total of 174 alumni (71%) responded. There were significant differences between graduates who trained in the two models. Those who trained in the integrated model were significantly more likely than others to report that they had consulted or planned treatment with a BH provider during residency and to report that their continuity clinic helped prepare them to collaborate with BH providers. They were somewhat more likely to believe that their overall residency training prepared them to manage BH issues in their current practice. CONCLUSIONS: These findings suggest that an integrated training environment, described in detail in the companion article in this issue, can enhance pediatric resident education in the management of BH problems and collaboration with BH specialists.
Topic(s):
Education & Workforce
See topic collection