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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).
12771 Results
7001
Measuring integrated care
Type:
Journal Article
Year:
2011
Publication Place:
Denmark
Abstract:
The positive outcomes of coordination of healthcare services are to an increasing extent becoming clear. However the complexity of the field is an inhibiting factor for vigorously designed trial studies. Conceptual clarity and a consistent theoretical frame-work are thus needed. While researchers respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser Permanente has been put forward as an example for European healthcare systems to follow, although the evidence base is far from conclusive. The thesis has five objectives: 1) To contribute to the understanding of the concept of integration in healthcare systems and to identify measurement methods to capture the multi-dimensional aspects of integrated healthcare delivery. 2) To assess the level of integration of the Danish healthcare system. 3) To assess the use of joint health plans as a tool for coordination between the regional and local level in the Danish healthcare system. 4) To compare the inputs and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine the associations between specific organizational factors and clinical integration within each system. The literature was systematically searched to identify methods for measurement of integrated healthcare delivery. A national cross-sectional survey was conducted among major professional stake-holders at five different levels of the Danish healthcare system. The survey data were used to allow for analysis of the level of integration achieved. Data from the survey were additionally used to investigate the use of joint health planning as a tool for coordination of regional-local healthcare delivery. Analysis of secondary data from the Danish healthcare system and Kaiser Permanente, California were used to compare population characteristics, professional staff, delivery structure, utilisation, quality measures and direct costs. A cross-sectional survey among primary care clinicians in Denmark and in Kaiser Permanente, Northern California was completed to allow for comparison of clinical integration in the two systems and system specific associated factors. In this thesis a conceptual framework and a model for assessment of the conditions for integrations as an intermediate healthcare system outcome are presented. Furthermore, the results show that integrated healthcare delivery can be measured: 24 methods are available and some are highly developed. However, the field is still in its early phase and guidelines for how to proceed are devised. It was confirmed on a national level that integration of care is a widespread challenge, and that only half or less than half of patients in need of integrated services receive such care. Options for decision makers and managers are discussed. From a theoretical perspective joint health plans as applied in Denmark do not match the degree of complexity in the healthcare system. It was therefore in agreement with the theoretical findings when major stakeholders agreed that the joint health plans had not been effective as a tool for coordination. Joint health planning processes should actively engage all stakeholders and a high degree of recurrent feedback are warranted. When comparing Kaiser Permanente, California with the Danish healthcare system, our study suggest that Kaiser Permanente has a population with more documented disease and higher operating costs, and performs better than the Danish healthcare system on the observed quality measures. Substantial differences were found in the perception of clinical integration in the two settings. More primary care clinicians in the Northern California region of Kaiser Permanente reported being part of a clinical integrated environment than did Danish general practitioners. By measuring the level of clinical integration in Kaiser Permanente using the Danish healthcare system as a point of reference our findings support the literature that points to the importance of integrated healthcare delivery as a driver for the performance results of Kaiser Permanente. However caution must be advised before making concrete conclusions due to the complexity of the matter and until more studies have been conducted. With this thesis an initial step has been taken into a new research field. Ongoing research will make it possible to deliver the evidence needed by decision makers, planners and managers - ultimately to benefit the patients.
Topic(s):
HIT & Telehealth
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, Key & Foundational
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Reference Links:
View the PubMed citation for Measuring integrated care
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7002
Measuring Perceived Level of Integration During the Process of Primary Care Behavioral Health Implementation
Type:
Journal Article
Year:
2018
Publication Place:
United States
Abstract:
Provider- and staff-perceived levels of integration were measured during implementation of a primary care behavioral health clinic; these data were used to tailor and evaluate quality improvement strategies. Providers and staff at an urban, academic, adult primary care clinic completed the 32-item Level of Integration Measure (LIM) at baseline and 7 months. The LIM assesses 6 domains of integrated care. Overall and domain scores were calibrated from 0 to 100, with >/=80 representing a highly integrated clinic. Response rate was 79% (N = 46/58) at baseline and 83% (N = 52/63) at follow-up. Overall, LIM score increased from 64.5 to 70.1, P = .001. The lowest scoring domains at baseline were targeted for quality improvement and increased significantly: integrated clinical practice, 60.0 versus 68.4, P < .001; systems integration, 57.0 versus 63.8, P = .001; and training, 56.7 versus 65.3, P = .001. Ongoing quality improvement, including organizational and financial strategies, is needed to achieve higher levels of integration.
Topic(s):
Financing & Sustainability
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Reference Links:
View the DOI record for Measuring Perceived Level of Integration During the Process of Primary Care Behavioral Health Implementation
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View the PubMed citation for Measuring Perceived Level of Integration During the Process of Primary Care Behavioral Health Implementation
7003
Measuring Person-centered Care: A Critical Comparative Review of Published Tools
Type:
Journal Article
Year:
2010
Publication Place:
United States
Abstract:
PURPOSE OF THE STUDY: to present a critical comparative review of published tools measuring the person-centeredness of care for older people and people with dementia. DESIGN AND METHODS: included tools were identified by searches of PubMed, Cinahl, the Bradford Dementia Group database, and authors' files. The terms "Person-centered," "Patient-centered" and "individualized" (US and UK spelling), were paired with "Alzheimer's disease," "older people," and "dementia" in various combinations. The tools were compared in terms of conceptual influences, perspectives studied and intended use, applicability, psychometric properties, and credibility. RESULTS: twelve tools eligible for review were identified. Eight tools were developed for evaluating long-term aged care, three for hospital-based care, and one for home care. One tool, Dementia Care Mapping, was dementia specific. A common limitation of the tools reviewed is that they are yet to be used and validated beyond the development period; thus, their validity, reliability, and applicability needs further exploration. Also, the perspective of people with dementia remains absent. IMPLICATIONS: the review demonstrates the availability of a multitude of tools for measurement of person-centered care in different settings and from different perspectives, even if further testing of the tools is needed. The conceptual underpinnings of the tools are rarely explicit, which makes it difficult to ascertain the conceptual comparability of the tools.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Measuring Person-centered Care: A Critical Comparative Review of Published Tools
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View the PubMed citation for Measuring Person-centered Care: A Critical Comparative Review of Published Tools
7007
Measuring Productivity in Primary Care Behavioral Health: A Delphi Study
Type:
Journal Article
Year:
2022
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Measuring Productivity in Primary Care Behavioral Health: A Delphi Study
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View the PubMed citation for Measuring Productivity in Primary Care Behavioral Health: A Delphi Study
7008
Measuring provider adherence to tobacco treatment guidelines: a comparison of electronic medical record review, patient survey, and provider survey
Type:
Journal Article
Year:
2005
Publication Place:
England
Abstract:
An accurate method of measuring primary care providers' tobacco counseling actions is needed for monitoring adherence to clinical practice guidelines. We compared three methods of measuring providers' tobacco counseling practices: electronic medical record (EMR) review, patient survey, and provider survey. We mailed a survey to 1,613 smokers seen by 114 Boston-area primary care providers during a 2-month period to assess what tobacco counseling actions had occurred at the visit (N = 766; 47% response rate). Smokers' reports were compared with the EMR and with their providers' self-reported usual tobacco counseling practices, derived from a provider survey (N = 110; 96% response rate). Patients reported receiving each counseling action more frequently than providers documented it in the EMR. Agreement between the patient survey and the EMR was poor for all 5A steps (kappa statistic = 0.01-0.22). Providers reported that they often or always performed each 5A action at a higher rate than indicated by EMR or patient report. However, providers who said they often or always performed individual 5A steps did not have consistently higher mean rates of EMR documentation or patient report than those who said they performed the 5A's less frequently. Little agreement was found among the three methods of measuring primary care providers' tobacco counseling actions. Implementing an EMR does not necessarily improve providers' documentation of tobacco interventions, but EMR adaptations that would standardize provider documentation of tobacco counseling might make the EMR a more reliable tool for monitoring providers' delivery of tobacco treatment services.
Topic(s):
HIT & Telehealth
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7009
Measuring psychological change during cognitive behaviour therapy in primary care: a Polish study using 'PSYCHLOPS' (Psychological Outcome Profiles)
Type:
Journal Article
Year:
2011
Publication Place:
United States
Abstract:
BACKGROUND: Psychological outcome measures are evolving into measures that depict progress over time. Interval measurement during therapy has not previously been reported for a patient-generated measure in primary care. We aimed to determine the sensitivity to change throughout therapy, using 'PSYCHLOPS' (Psychological Outcome Profiles), and to determine if new problems appearing during therapy diminish overall improvement. METHODS: Responses to PSYCHLOPS, pre-, during- and post-therapy were compared. SETTING: patients offered brief cognitive behaviour therapy in primary care in Poland. RESULTS: 238 patients completed the pre-therapy questionnaire, 194 (81.5%) the during-therapy questionnaire and 142 the post-therapy questionnaire (59.7%). For those completing all three questionnaires (n = 135), improvement in total scores produced an overall Effect Size of 3.1 (2.7 to 3.4). We estimated change using three methods for dealing with missing values. Single and multiple imputation did not significantly change the Effect Size; 'Last Value Carried Forward', the most conservative method, produced an overall Effect Size of 2.3 (1.9 to 2.6). New problems during therapy were reported by 81 patients (60.0%): new problem and original problem scores were of similar magnitude and change scores were not significantly different when compared to patients who did not report new problems. CONCLUSION: A large proportion of outcome data is lost when outcome measures depend upon completed end of therapy questionnaires. The use of a during-therapy measure increases data capture. Missing data still produce difficulties in interpreting overall effect sizes for change. We found no evidence that new problems appearing during therapy hampered overall recovery.
Topic(s):
General Literature
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7010
Measuring quality of life in opioid-dependent people: a systematic review of assessment instruments
Type:
Journal Article
Year:
2017
Publication Place:
Netherlands
Abstract:
PURPOSE: Opioid dependence is a chronic relapsing disorder. Despite increasing research on quality of life (QOL) in people with opioid dependence, little attention has been paid to the instruments used. This systematic review examines the suitability of QOL instruments for use in opioid-dependent populations and the instruments' quality. METHODS: A systematic search was performed in the databases Medline, PsycInfo, The Cochrane Library, and CINAHL. Articles were eligible if they assessed QOL of opioid-dependent populations using a validated QOL instrument. Item content relevance to opioid-dependent people was evaluated by means of content analysis, and instrument properties were assessed using minimum standards for patient-reported outcome measures. RESULTS: Eighty-nine articles were retrieved, yielding sixteen QOL instruments, of which ten were assessed in this review. Of the ten instruments, six were disease specific, but none for opioid dependence. Two instruments had good item content relevance. The conceptual and measurement model were described in seven instruments. Four instruments were developed with input from the respective target population. Eight instruments had low respondent and administrator burden. Psychometric properties were either not assessed in opioid-dependent populations or were inconclusive or moderate. CONCLUSIONS: No instrument scored perfectly on both the content and properties. The limited suitability of instruments for opioid-dependent people hinders accurate and sensitive measurement of QOL in this population. Future research is in need of an opioid dependence-specific QOL instrument to measure the true impact of the disease on people's lives and to evaluate treatment-related services.
Topic(s):
Measures
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Measuring quality of life in opioid-dependent people: a systematic review of assessment instruments
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View the PubMed citation for Measuring quality of life in opioid-dependent people: a systematic review of assessment instruments
7013
Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach
Type:
Journal Article
Year:
2017
Publication Place:
United States
Abstract:
To explore the cost for individual practices to become more patient-centered, we inventoried and calculated the cost of costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance. There were 3 key findings. The cost of each PCMH-related clinical activity can be classified in 1 of 3 major categories. Cost offsets can be used to defray part of the cost recognition. The cost of PCMH transformation varied by practice with no clear level or pattern of costs. Our study suggests that small- and medium-sized practices may experience difficulty with the financial burden of PCMH recognition.
Topic(s):
Financing & Sustainability
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, Medical Home
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Reference Links:
View the DOI record for Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach
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View the PubMed citation for Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach
7016
Measuring the integration of primary care and behavioral health services
Type:
Journal Article
Year:
2019
Publication Place:
United States
Topic(s):
HIT & Telehealth
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, Measures
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Reference Links:
View the DOI record for Measuring the integration of primary care and behavioral health services
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View the PubMed citation for Measuring the integration of primary care and behavioral health services
7017
Measuring the quality of interprofessional collaboration in child mental health collaborative care
Type:
Journal Article
Year:
2012
Publication Place:
Netherlands
Abstract:
OBJECTIVE: This pilot study examines the potential utility of the Perception of Interprofessional Collaboration Model and the shared decision-making scales in evaluating the quality of partnership in child mental health collaborative care. METHODS: Ninety-six primary care professionals working with children and youth responded to an internet survey which included the Perception of Interprofessional Collaboration Model scale (PINCOM-Q) and an adapted version of a shared decision-making scale (Echelle de confort decisionnel, partenaire-ECD-P). The perceptions of child mental health professionals were compared with those of other professionals working with children. RESULTS: The PINCOM-Q and the ECD-P scales had an excellent internal consistency and they were moderately correlated. Child mental health professionals' Individual Interprofessional Collaboration scores from the PINCOM-Q individual aspects subscale were better than that of other child professionals. CONCLUSION: These scales may be interesting instruments to measure the quality of partnership in child mental health collaborative care settings. Research needs to replicate these findings and to determine whether the quality of collaboration is a predictor of mental health outcome.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links:
View the PubMed citation for Measuring the quality of interprofessional collaboration in child mental health collaborative care
7018
Measuring treatment attrition at various stages of engagement in Opioid Agonist Treatment in Ontario Canada using a cascade of care framework
Type:
Journal Article
Year:
2022
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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7019
Measuring Variation Across Dimensions of Integrated Care: The Maryland Medicaid Health Home Model
Type:
Journal Article
Year:
2018
Publication Place:
United States
Topic(s):
Measures
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, Medical Home
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Reference Links:
View the DOI record for Measuring Variation Across Dimensions of Integrated Care: The Maryland Medicaid Health Home Model
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View the PubMed citation for Measuring Variation Across Dimensions of Integrated Care: The Maryland Medicaid Health Home Model