Literature Collection

5041

Incentivizing Primary Care Providers to Innovate: Building Medical Homes in the Post-Katrina New Orleans Safety Net

Type: Journal Article

Authors: Diane R. Rittenhouse, Laura A. Schmidt, Kevin J. Wu, James Wiley

Year: 2014

Topic(s):

,

Export Citation: RIS

View details

5042

Incidence and predictors of suicide attempts among primary-care patients with depressive disorders: a 5-year prospective study

Type: Journal Article

Authors: K. Riihimaki, M. Vuorilehto, T. Melartin, J. Haukka, E. Isometsa

Year: 2014

Topic(s):

Export Citation: RIS

View details

5043

Incidence of future arrests in adults involved in the criminal justice system with opioid use disorder receiving extended release naltrexone compared to treatment as usual

Type: Journal Article

Authors: W. E. Soares III, D. Wilson, M. S. Gordon, J. D. Lee, E. V. Nunes, C. P. O'Brien, M. Shroff, P. D. Friedmann

Year: 2019

Publication Place: Ireland

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

5044

Incidence of Naloxone Redosing in the Age of the New Opioid Epidemic

Type: Journal Article

Authors: Ronald Klebacher, Matthew I. Harris, Navin Ariyaprakai, Ammundeep Tagore, Vince Robbins, Larissa Sophia Dudley, Robert Bauter, Susmith Koneru, Ryan D. Hill, Eric Wasserman, Andrew Shanes, Mark A. Merlin

Year: 2017

Publication Place: England

Abstract:

STUDY OBJECTIVE: Naloxone, an opioid-antagonist deliverable by an intra-nasal route, has become widely available and utilized by law enforcement officers as well as basic life support (BLS) providers in the prehospital setting. This study aimed to determine the frequency of repeat naloxone dosing in suspected narcotic overdose (OD) patients and identify patient characteristics. METHODS: A retrospective chart review of patients over 17 years of age with suspected opioid overdose, treated with an initial intranasal (IN) dose of naloxone and subsequently managed by paramedics, was performed from April 2014 to June 2016. Demographic data was analyzed using descriptive statistics to identify those aspects of the history, physical exam findings. Results: A sample size of 2166 patients with suspected opioid OD received naloxone from first responders. No patients who achieved GCS 15 after treatment required redosing; 195 (9%) received two doses and 53 patients received three doses of naloxone by advanced life support. Patients were primarily male (75.4%), Caucasian (88.2%), with a mean age of 36.4 years. A total of 76.7% of patients were found in the home, 23.1% had a suspected mixed ingestion, and 27.2% had a previous OD. Two percent of all patients required a third dose of naloxone. CONCLUSION: In this prehospital study, we confirmed that intranasal naloxone is effective in reversing suspected opioid toxicity. Nine percent of patients required two or more doses of naloxone to achieve clinical reversal of suspected opioid toxicity. Two percent of patients received a third dose of naloxone.

Topic(s):

Reference Links:

Export Citation: RIS

View details

5045

Including safety-net providers in integrated delivery systems: issues and options for policymakers

Type: Journal Article

Authors: K. Witgert, C. Hess

Year: 2012

Publication Place: United States

Abstract: Health care reform legislation has spurred efforts to develop integrated health care delivery systems that seek to coordinate the continuum of health services. These systems may be of particular benefit to patients who face barriers to accessing care or have multiple health conditions. But it remains to be seen how safety-net providers, including community health centers and public hospitals--which have long experience in caring for these vulnerable populations--will be included in integrated delivery systems. This issue brief explores key considerations for incorporating safety-net providers into integrated delivery systems and discusses the roles of state and federal agencies in sup-porting and testing models of integrated care delivery. The authors conclude that the most important principles in creating integrated delivery systems for vulnerable populations are: (1) an emphasis on primary care; (2) coordination of all care, including behavioral, social, and public health services; and (3) accountability for population health outcomes.

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

5046

Including the family in research evaluating integrated care: A call for expanding investigators' scope beyond single-person measures

Type: Journal Article

Authors: T. J. Mendenhall, J. E. Ballard

Year: 2014

Topic(s):

Reference Links:

Export Citation: RIS

View details

5047

Inclusion of persons with mental illness in patient-centred medical homes: cross-sectional findings from Ontario, Canada

Type: Journal Article

Authors: L. S. Steele, A. Durbin, L. M. Sibley, R. Glazier

Year: 2013

Publication Place: Canada

Abstract: BACKGROUND: In Ontario, Canada, the patient-centred medical home is a model of primary care delivery that includes 3 model types of interest for this study: enhanced fee-for-service, blended capitation, and team-based blended capitation. All 3 models involve rostering of patients and have similar practice requirements but differ in method of physician reimbursement, with the blended capitation models incorporating adjustments for age and sex, but not case mix, of rostered patients. We evaluated the extent to which persons with mental illness were included in physicians' total practices (as rostered and non-rostered patients) and were included on physicians' rosters across types of medical homes in Ontario. METHODS: Using population-based administrative data, we considered 3 groups of patients: those with psychotic or bipolar diagnoses, those with other mental health diagnoses, and those with no mental health diagnoses. We modelled the prevalence of mental health diagnoses and the proportion of patients with such diagnoses who were rostered across the 3 medical home model types, controlling for demographic characteristics and case mix. RESULTS: Compared with enhanced fee-for-service practices, and relative to patients without mental illness, the proportions of patients with psychosis or bipolar disorders were not different in blended capitation and team-based blended capitation practices (rate ratio [RR] 0.91, 95% confidence interval [CI] 0.82-1.01; RR 1.06, 95% CI 0.96-1.17, respectively). However, there were fewer patients with other mental illnesses (RR 0.94, 95% CI 0.90-0.99; RR 0.89, 95% CI 0.85-0.94, respectively). Compared with expected proportions, practices based on both capitation models were significantly less likely than enhanced fee-for-service practices to roster patients with psychosis or bipolar disorders (for blended capitation, RR 0.92, 95% CI 0.90-0.93; for team-based capitation, RR 0.92, 95% CI 0.88-0.93) and also patients with other mental illnesses (for blended capitation, RR 0.94, 95% CI 0.92-0.95; for team-based capitation, RR 0.93, 95% CI 0.92-0.94). INTERPRETATION: Persons with mental illness were under-represented in the rosters of Ontario's capitation-based medical homes. These findings suggest a need to direct attention to the incentive structure for including patients with mental illness.

Topic(s):

, ,

Reference Links:

Export Citation: RIS

View details

5048

Inclusion of substance abuse training in CACREP-accredited programs (Substance Abuse Training in Accredited CACREP Questionnaire)

Type: Journal Article

Authors: K. M. Salyers, M. H. Ritchie, W. S. Cochrane, C. P. Roseman

Year: 2006

Topic(s):

, ,

Export Citation: RIS

View details

5049

Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) 49. HHS Publication No. (SMA): 09-4380

Type: Government Report

Authors: Center for Substance Abuse Treatment

Year: 2009

Publication Place: Rockville, MD

Abstract: This literature review is part of the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Treatment Improvement Protocol (TIP) 49, Incorporating Alcohol Pharmacotherapies Into Medical Practice. Developed by a panel of experts for SAMHSA's Center for Substance Abuse Treatment (CSAT), the TIP can assist physicians and other medical professionals in providing pharmacologic treatment, combined with psychosocial therapy, for patients who are alcohol dependent, both in primary care settings and in specialized substance abuse treatment settings. TIP 49 focuses on the best currently recognized clinical practices for the medical maintenance of patients with alcohol use disorders (AUDs), using the four medications (disulfiram, oral naltrexone, injectable naltrexone, and acamprosate) approved by the U.S. Food and Drug Administration (FDA) for this purpose. The TIP presents best practices according to the scientific literature and the clinical experts who developed the TIP. This literature review emphasizes recent research published from 2000 to 2007 but also includes classic research studies published before 2000.

Topic(s):

Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

PDF (945.27 KB)

Reference Links:

PDF (945.27 KB)

Export Citation: RIS

View details

5050

Incorporating mental health checkups into adolescent primary care visits

Type: Journal Article

Authors: P. L. Allen, L. McGuire

Year: 2011

Publication Place: United States

Topic(s):

Reference Links:

Export Citation: RIS

View details

5051

Incorporating Patients' Social Determinants of Health into Hypertension and Depression Care: A Pilot Randomized Controlled Trial

Type: Journal Article

Authors: H. F. McClintock, H. R. Bogner

Year: 2017

Publication Place: United States

Abstract: The objective of this study was to carry out a randomized controlled pilot trial to test the effectiveness of an integrated intervention for hypertension and depression incorporating patients' social determinants of health (enhanced intervention) versus an integrated intervention alone (basic intervention). In all, 54 patients were randomized. An electronic monitor was used to measure blood pressure, and the nine-item Patient Health Questionnaire (PHQ-9) assessed depressive symptoms. Patients in the enhanced intervention had a significantly improved PHQ-9 mean change from baseline in comparison with patients in the basic intervention group at 12 weeks (p = 0.024). Patients in the enhanced intervention had a significantly improved systolic and diastolic blood pressure mean change from baseline in comparison with patients in the basic intervention group at 12 weeks (p = 0.003 and p = 0.019, respectively). Our pilot trial results indicate integrated care management that addresses the social determinants of health for patients with hypertension and depression may be effective.

Topic(s):

Reference Links:

Export Citation: RIS

View details

5052

Incorporating recognition and management of perinatal and postpartum depression into pediatric practice

Type: Journal Article

Authors: M. F. Earls, Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics

Year: 2010

Publication Place: United States

Abstract: Every year, more than 400,000 infants are born to mothers who are depressed, which makes perinatal depression the most underdiagnosed obstetric complication in America. Postpartum depression leads to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development. Pediatric practices, as medical homes, can establish a system to implement postpartum depression screening and to identify and use community resources for the treatment and referral of the depressed mother and support for the mother-child (dyad) relationship. This system would have a positive effect on the health and well-being of the infant and family. State chapters of the American Academy of Pediatrics, working with state Early Periodic Screening, Diagnosis, and Treatment (EPSDT) and maternal and child health programs, can increase awareness of the need for perinatal depression screening in the obstetric and pediatric periodicity of care schedules and ensure payment. Pediatricians must advocate for workforce development for professionals who care for very young children and for promotion of evidence-based interventions focused on healthy attachment and parent-child relationships.

Topic(s):

Reference Links:

Export Citation: RIS

View details

5053

Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice

Type: Journal Article

Authors: J. Rafferty, G. Mattson, M. F. Earls, M. W. Yogman, Committee on Psychosocial Aspects of Child and Family Health

Year: 2019

Publication Place: United States

Topic(s):

, ,

Reference Links:

Export Citation: RIS

View details

5054

Increase in untreated cases of psychiatric disorders during the transition to adulthood

Type: Journal Article

Authors: W. E. Copeland, L. Shanahan, M. Davis, B. J. Burns, A. Angold, E. J. Costello

Year: 2015

Publication Place: United States

Abstract: OBJECTIVE: During the transition to adulthood, youths face challenges that may limit their likelihood of obtaining services for psychiatric problems. The goal of this analysis was to estimate changes in rates of service use and untreated psychiatric disorders during the transition from adolescence to adulthood. METHODS: In a prospective, population-based study, participants were assessed up to four times in adolescence (ages 13-16; 3,983 observations of 1,297 participants, 1993-2000) and three times in young adulthood (ages 19, 21, and 24-26; 3,215 observations of 1,273 participants, 1999-2010). Structured diagnostic interviews were used to assess service need (participants meeting DSM-IV diagnostic criteria for a psychiatric disorder) and use of behavioral services in 21 service settings in the past three months. RESULTS: During young adulthood, 28.9% of cases of psychiatric disorders were associated with some treatment, compared with a rate of 50.9% for the same participants during adolescence. This decrease included a near-complete drop in use of educational and vocational services as well as declines in use of specialty behavioral services. Young adults most frequently accessed services in specialty behavioral or general medical settings. Males, African Americans, participants with substance dependence, and participants living independently were least likely to get treatment. For cases of psychiatric disorders among young adults, insurance and poverty status were unrelated to likelihood of service use. CONCLUSIONS: Young adults were much less likely to receive treatment for psychiatric problems than they were as adolescents. Public policy must address gaps in service use during the transition to adulthood.

Topic(s):

Reference Links:

Export Citation: RIS

View details

5055

Increased access to evidence-based primary mental health care: Will the implementation match the rhetoric?

Type: Journal Article

Authors: I. B. Hickie, P. D. McGorry

Year: 2007

Publication Place: Australia

Abstract: There is clear evidence that coordinated systems of medical and psychological care ("collaborative care") are superior to single-provider-based treatment regimens. Although other general practice-based mental health schemes promoted collaborative care, the new Medicare Benefits Schedule payments revert largely to individual-provider service systems and fee-for-service rebates. Such systems have previously resulted in high out-of-pocket expenses, poor geographical and socioeconomic distribution of specialist services, and proliferation of individual-provider-based treatments rather than collaborative care. The new arrangements for broad access to psychological therapies should provide the financial basis for major structural reform. Unless this reform is closely monitored for equity of access, degree of out-of-pocket expenses, extent of development of evidence-based collaborative care structures, and impact on young people in the early phases of mental illness, we may waste this opportunity. The responsibility for achieving the best outcome does not lie only with governments. To date, the professions have not placed enough emphasis on systematically adopting evidence-based forms of collaborative care.

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

5056

Increased demand for amphetamine treatment in rural Australia

Type: Journal Article

Authors: J. Allan, R. H. L. Ip, M. Kemp, N. Snowdon

Year: 2019

Abstract: BACKGROUND: A substantial increase in substance treatment episodes for methamphetamine problems suggests characteristics of the treatment population could have changed and that targeted treatment programs are required. To determine who methamphetamine treatment should be designed for this study has two aims. First, to empirically describe changes in amphetamine treatment presentations to a rural NSW drug and alcohol treatment agency over time. Second, to examine how these characteristics may affect the likelihood of being treated for amphetamines compared to other drugs. METHOD: The Australian Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS-NMDS) containing closed treatment episodes from a single agency from three time periods was used. Characteristics of people receiving amphetamine treatments in these three periods were compared and the effects of these characteristics on the odds of being treated for amphetamine were estimated using a logistic regression model. The characteristics utilised in the analysis include age, sex, Indigenous status, usual accommodation, living arrangement, source of referral and source of income. RESULTS: The proportion of amphetamine treatment episodes doubled from 2006/2007 to 2015/2016 and overtook alcohol as the most commonly treated principal drug of concern. The estimated proportion of amphetamine treatments showed an increment across all ages and for men and women. It was found that younger people, women, people in temporary accommodation or homeless, people who were self-referred and people whose main source of income was not through employment are more likely to be treated for amphetamine use. CONCLUSION: Significant changes over time in the age, sex and Indigenous status of people receiving treatment for amphetamine as the principal drug of concern requires service delivery to match demand from younger people, particularly women; and Indigenous people. The needs and preferences for treatment of younger women who use amphetamine will be important factors in treatment planning service providers who are more used to providing treatment for young men who use cannabis and older men who use alcohol. Further research on women's experiences in treatment and outcomes would be useful for informing treatment practices.

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

5057

Increased medical cost metrics for patients 50 years of age and older in the collaborate care model of treatment for depression

Type: Journal Article

Authors: K. B. Angstman, Y. C. Doganer, R. S. DeJesus, J. E. Rohrer

Year: 2016

Publication Place: England

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

5058

Increased medical utilization and psychiatric comorbidity following a new diagnosis of methamphetamine use disorder

Type: Journal Article

Authors: W. C. Lee, H. M. Chang, M. C. Huang, C. H. Pan, S. S. Su, S . Y. Tsai, C. C. Chen, C. J. Kuo

Year: 2021

Publication Place: England

Abstract:

BACKGROUND: Evidence of patterns of medical utilization and distribution of comorbidities among individuals using methamphetamine remains limited. OBJECTIVE: This study aims to investigate changes in medical utilization and comorbidities before and after a diagnosis of methamphetamine use disorder. METHODS: A total of 3321 cases (79% were male) of methamphetamine use disorder between January 1, 1996, and December 31, 2012, were identified from Psychiatric Inpatient Medical Claims database in Taiwan. Information was collected on demographics, diagnoses, and medical utilizations. The date of newly diagnosed with methamphetamine use disorder was defined as the baseline. Mirror-image study design was used to compare changes in medical utilization and comorbidities between the pre-baseline period (within 1 year before diagnosis) and the post-baseline period (within 1 year after diagnosis). Conditional logistic regression was used to estimate changes in medical utilization and comorbidities. RESULTS: Most cases (77%) were first identified in a psychiatric department. There is a significant increase (P < .001) in psychiatric admission (odds ratio[OR] = 2.19), psychiatric emergency visits (OR = 1.31), and psychiatric outpatient visits (OR = 1.15) after diagnosis. Multivariable analysis revealed significantly increased risks (P < .001) of non-methamphetamine drug induced mental disorders (adjusted OR[aOR] = 29.47), schizophrenia (aOR = 2.62), bipolar disorder (aOR = 2.14), organic mental disorder (aOR = 1.82), and upper respiratory tract infection (aOR = 2.03) after diagnosis. CONCLUSIONS: We found significant increases of medical utilization and psychiatric comorbidities after diagnosed with methamphetamine use disorder. These findings may reflect the problem of delayed diagnosis and treatment. Enhancement of early identification of methamphetamine use disorder in general practice is required for early intervention and decreased subsequent morbidities.

Topic(s):

, ,

Reference Links:

Export Citation: RIS

View details

5059

Increasing Access to and Utilization of Behavioral Health Care Through Integrated Primary Care

Type: Journal Article

Authors: C. Hostutler, N. Wolf, T. Snider, C. Butz, A. R. Kemper, E. Butter

Year: 2023

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

5060

Increasing access to behavioral health care through technology

Type: Government Report

Year: 2013

Publication Place: Rockville, MD

Abstract: Insights in this report were shared by a select group of HRSA-funded health centers in a March 2012 daylong meeting, convened by the U.S. Department of Health and Human Services (HHS) and its Health Resources and Services Administration's (HRSA) Office of Special Health Affairs. The meeting was held in collaboration with HRSA's Bureau of Primary Care (which oversees the Health Centers Program), the HRSA Office of Rural Health Policy's Office for the Advancement of Telehealth, and HHS's Substance Abuse and Mental Health Services Administration's (SAMHSA) Telemental Health Program.

Topic(s):

,

Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

PDF (386.66 KB)

Reference Links: PDF (386.66 KB)

Export Citation: RIS

View details