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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).
11231 Results
743
Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: Value-based payment initiatives, such as the Medicare Shared Savings Program (MSSP), offer the possibility of using financial incentives to drive improvements in mental health and substance use outcomes. In the past 2 years, Accountable Care Organizations (ACOs) participating in the MSSP began to publicly report on one behavioral health outcome-Depression Remission at Twelve Months, which may indicate how value-based payment incentives have impacted mental health and substance use, and if reforms are needed. For ACOs that meaningfully reported performance on the depression remission measure in 2017, the median rate of depression remission at 12 months was 8.33%. A recent meta-analysis found that the average rate of spontaneous depression remission at 12 months absent treatment was approximately 53%. Although a number of factors likely explain these results, the current ACO design does not appear to incentivize improved behavioral health outcomes. Four changes in value-based payment incentive design may help to drive better outcomes: (1) making data collection easier, (2) increasing the salience of incentives, (3) building capacity to implement new interventions, and (4) creating safeguards for inappropriate treatment or reporting.
Topic(s):
Financing & Sustainability
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links: 
View the DOI record for Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health
View DOI Record
View the PubMed citation for Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health744
Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: Value-based payment initiatives, such as the Medicare Shared Savings Program (MSSP), offer the possibility of using financial incentives to drive improvements in mental health and substance use outcomes. In the past 2 years, Accountable Care Organizations (ACOs) participating in the MSSP began to publicly report on one behavioral health outcome-Depression Remission at Twelve Months, which may indicate how value-based payment incentives have impacted mental health and substance use, and if reforms are needed. For ACOs that meaningfully reported performance on the depression remission measure in 2017, the median rate of depression remission at 12 months was 8.33%. A recent meta-analysis found that the average rate of spontaneous depression remission at 12 months absent treatment was approximately 53%. Although a number of factors likely explain these results, the current ACO design does not appear to incentivize improved behavioral health outcomes. Four changes in value-based payment incentive design may help to drive better outcomes: (1) making data collection easier, (2) increasing the salience of incentives, (3) building capacity to implement new interventions, and (4) creating safeguards for inappropriate treatment or reporting.
Topic(s):
Financing & Sustainability
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health
View DOI Record
View the PubMed citation for Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health745
Accounting for individual differences and timing of events: estimating the effect of treatment on criminal convictions in heroin users
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: BACKGROUND: The reduction of crime is an important outcome of opioid maintenance treatment (OMT). Criminal intensity and treatment regimes vary among OMT patients, but this is rarely adjusted for in statistical analyses, which tend to focus on cohort incidence rates and rate ratios. The purpose of this work was to estimate the relationship between treatment and criminal convictions among OMT patients, adjusting for individual covariate information and timing of events, fitting time-to-event regression models of increasing complexity. METHODS: National criminal records were cross linked with treatment data on 3221 patients starting OMT in Norway 1997-2003. In addition to calculating cohort incidence rates, criminal convictions was modelled as a recurrent event dependent variable, and treatment a time-dependent covariate, in Cox proportional hazards, Aalen's additive hazards, and semi-parametric additive hazards regression models. Both fixed and dynamic covariates were included. RESULTS: During OMT, the number of days with criminal convictions for the cohort as a whole was 61% lower than when not in treatment. OMT was associated with reduced number of days with criminal convictions in all time-to-event regression models, but the hazard ratio (95% CI) was strongly attenuated when adjusting for covariates; from 0.40 (0.35, 0.45) in a univariate model to 0.79 (0.72, 0.87) in a fully adjusted model. The hazard was lower for females and decreasing with older age, while increasing with high numbers of criminal convictions prior to application to OMT (all p < 0.001). The strongest predictors were level of criminal activity prior to entering into OMT, and having a recent criminal conviction (both p < 0.001). The effect of several predictors was significantly time-varying with their effects diminishing over time. CONCLUSIONS: Analyzing complex observational data regarding to fixed factors only overlooks important temporal information, and naive cohort level incidence rates might result in biased estimates of the effect of interventions. Applying time-to-event regression models, properly adjusting for individual covariate information and timing of various events, allows for more precise and reliable effect estimates, as well as painting a more nuanced picture that can aid health care professionals and policy makers.
Topic(s):
Opioids & Substance Use
See topic collection
746
Accounting for the uncounted: Physical and affective distress in individuals dropping out of oral naltrexone treatment for opioid use disorder
Type: Journal Article
Year: 2018
Publication Place: Ireland
Topic(s):
Medically Unexplained Symptoms
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, Opioids & Substance Use
See topic collection
747
Acculturation differences in communicating information about child mental health between Latino parents and primary care providers
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: Significant Latino-white disparities in youth mental health care access and quality exist yet little is known about Latino parents' communication with providers about youth mental health and the role of acculturation in influencing this communication. We estimated regression models to assess the association between time in the US and the number of psychosocial issues discussed with the medical assistant (MA) and doctor, adjusting for child and parent mental health and sociodemographics. Other proxies of acculturation were also investigated including measures of Spanish and English language proficiency and nativity. Parent's length of time in the US was positively associated with their communication of: their child's psychosocial problems with their child's MA, stress in their own life with their child's MA, and their child's school problems with their child's doctor. These differences were especially apparent for parents living in the US for >10 years. Parent-child language discordance, parent and child nativity were also significantly associated with communication of psychosocial problems. Greater provider and MA awareness of variation in resistance to communicating psychosocial issues could improve communication, and improve the prevention, diagnosis and treatment of youth mental illness.
Topic(s):
Healthcare Disparities
See topic collection
749
Accuracy of diagnosing depression in primary care: the impact of chronic somatic and psychiatric co-morbidity
Type: Journal Article
Year: 2005
Publication Place: England
Abstract: BACKGROUND: Depression is highly co-morbid with both psychiatric and chronic somatic disease. These types of co-morbidity have been shown to exert opposite effects on underdiagnosis of depression by general practitioners (GPs). However, past research has not addressed their combined effect on underdiagnosis of depression. METHOD: Co-morbidity data on 191 depressed primary-care patients selected by a two-stage sampling procedure were analysed. Diagnoses of major depression and/or dysthymia in the last 12 months were assessed using a standardized psychiatric interview (CIDI) and compared with depression diagnoses registered by GPs in patient contacts during the same period. Presence of psychiatric and chronic somatic co-morbidity was determined using the CIDI and contact registration, respectively. RESULTS: Regression analysis showed a significant interaction effect between psychiatric and chronic somatic co-morbidity on GPs' diagnosis of depression, while taking into account the effects of sociodemographic variables, depression severity and number of GP contacts. Subsequent stratified analysis revealed that in patients without chronic somatic co-morbidity, a lower educational level, a less severe depression, and fewer GP contacts all significantly increased the likelihood of not being diagnosed as depressed. In contrast, in patients with chronic somatic co-morbidity, only having no psychiatric co-morbidity significantly decreased the likelihood of receiving a depression diagnosis. CONCLUSIONS: Our results indicate that the effects of psychiatric co-morbidity and other factors on underdiagnosis of depression by GPs differ between depressed patients with and without chronic somatic co-morbidity. Efforts to improve depression diagnosis by GPs seem to require different strategies for depressed patients with and without chronic somatic co-morbidity.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links: View the PubMed citation for Accuracy of diagnosing depression in primary care: the impact of chronic somatic and psychiatric co-morbidity
750
Accuracy of electronic patient record registration in chronic psychosis--a case study of a group practice
Type: Journal Article
Year: 2003
Publication Place: Netherlands
Topic(s):
HIT & Telehealth
See topic collection
Reference Links: View the PubMed citation for Accuracy of electronic patient record registration in chronic psychosis--a case study of a group practice
751
Accuracy of Electronically Reported "Meaningful Use" Clinical Quality Measures: A Cross-sectional Study
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: Chinese translation BACKGROUND: The federal Electronic Health Record Incentive Program requires electronic reporting of quality from electronic health records, beginning in 2014. Whether electronic reports of quality are accurate is unclear. OBJECTIVE: To measure the accuracy of electronic reporting compared with manual review. DESIGN: Cross-sectional study. SETTING: A federally qualified health center with a commercially available electronic health record. PATIENTS: All adult patients eligible in 2008 for 12 quality measures (using 8 unique denominators) were identified electronically. One hundred fifty patients were randomly sampled per denominator, yielding 1154 unique patients. MEASUREMENTS: Receipt of recommended care, assessed by both electronic reporting and manual review. Sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and absolute rates of recommended care were measured. RESULTS: Sensitivity of electronic reporting ranged from 46% to 98% per measure. Specificity ranged from 62% to 97%, positive predictive value from 57% to 97%, and negative predictive value from 32% to 99%. Positive likelihood ratios ranged from 2.34 to 24.25 and negative likelihood ratios from 0.02 to 0.61. Differences between electronic reporting and manual review were statistically significant for 3 measures: Electronic reporting underestimated the absolute rate of recommended care for 2 measures (appropriate asthma medication [38% vs. 77%; P < 0.001] and pneumococcal vaccination [27% vs. 48%; P < 0.001]) and overestimated care for 1 measure (cholesterol control in patients with diabetes [57% vs. 37%; P = 0.001]). LIMITATION: This study addresses the accuracy of the measure numerator only. CONCLUSION: Wide measure-by-measure variation in accuracy threatens the validity of electronic reporting. If variation is not addressed, financial incentives intended to reward high quality may not be given to the highest-quality providers. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
Topic(s):
HIT & Telehealth
See topic collection
Reference Links:
View the DOI record for Accuracy of Electronically Reported "Meaningful Use" Clinical Quality Measures: A Cross-sectional Study
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View the PubMed citation for Accuracy of Electronically Reported "Meaningful Use" Clinical Quality Measures: A Cross-sectional Study753
Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic
Type: Journal Article
Year: 2021
Abstract:
To assess whether primary care medical homes (PCMHs) are accurately identified for patients receiving care in a specialty mental health clinic within an integrated public delivery system. This study reviewed the electronic records of patients in a large urban mental health clinic. The study defined 'matching PCMH' if the same primary care clinic was listed in both the mental health and medical electronic records. This study designated all others as 'PCMH unknown.' This study assessed whether demographic factors predicted PCMH status using chi-square tests. Among 229 patients (66% male; mean age 49; 36% White, 30% Black, and 17% Asian), 72% had a matching PCMH. Sex, age, race, psychiatric diagnosis, and psychotropic medication use were not associated with matching PCMH. To improve care coordination and health outcomes for people with severe mental illness, greater efforts are needed to ensure the accurate designation of PCMHs in all mental health patient electronic records.
Topic(s):
Healthcare Disparities
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic
View DOI Record
View the PubMed citation for Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic754
Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
To assess whether primary care medical homes (PCMHs) are accurately identified for patients receiving care in a specialty mental health clinic within an integrated public delivery system. This study reviewed the electronic records of patients in a large urban mental health clinic. The study defined 'matching PCMH' if the same primary care clinic was listed in both the mental health and medical electronic records. This study designated all others as 'PCMH unknown.' This study assessed whether demographic factors predicted PCMH status using chi-square tests. Among 229 patients (66% male; mean age 49; 36% White, 30% Black, and 17% Asian), 72% had a matching PCMH. Sex, age, race, psychiatric diagnosis, and psychotropic medication use were not associated with matching PCMH. To improve care coordination and health outcomes for people with severe mental illness, greater efforts are needed to ensure the accurate designation of PCMHs in all mental health patient electronic records.
Topic(s):
Healthcare Disparities
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic
View DOI Record
View the PubMed citation for Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic755
Accuracy of referring psychiatric diagnosis on a consultation-liaison service
Type: Journal Article
Year: 2003
Publication Place: United States
Abstract: The authors determined the accuracy of the initial psychiatric diagnosis of primary medical providers requesting psychiatric consultation in a general medical inpatient setting. A retrospective review of 346 consecutive psychiatric consultations was conducted in which the initial diagnostic impression of primary medical providers was compared with the final psychiatric diagnosis. Accuracy rates for cognitive disorders, substance use disorders, and depressive disorders were 100%, 88.9%, and 53.6%, respectively. Thus, initial diagnoses of a cognitive or substance use disorder by primary medical providers are likely to be accurate, whereas an initial diagnosis of a depressive disorder will be inaccurate in approximately half of the cases.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links: View the PubMed citation for Accuracy of referring psychiatric diagnosis on a consultation-liaison service
759
Achieving cost control, care coordination, and quality improvement through incremental payment system reform
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: The healthcare reform goal of increasing eligibility and coverage cannot be realized without simultaneously achieving control over healthcare costs. The reform of existing payment systems can provide the financial incentive for providers to deliver care in a more coordinated and efficient manner with minimal changes to existing payer and provider infrastructure. Pay for performance, best practice pricing, price discounting, alignment of incentives, the medical home, payment by episodes, and provider performance reports are a set of payment reforms that can result in lower costs, better coordination of care, improved quality of care, and increased consumer involvement. These reforms can produce immediate Medicare annual savings of $10 billion and create the framework for future savings by establishing financial incentives for long-term provider behavior changes that can lead to lower costs.
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Policy
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Reference Links:
View the DOI record for Achieving cost control, care coordination, and quality improvement through incremental payment system reform
View DOI Record
View the PubMed citation for Achieving cost control, care coordination, and quality improvement through incremental payment system reform760
Achieving same-day access in integrated primary care
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
General Literature
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