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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
9053
Specialists/subspecialists and the patient-centered medical home
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: This article provides an overview of the Patient-Centered Medical Home (PCMH) care model. It provides a history and definition of the concept, a discussion of its growing acceptance by the health-care community, and a review of current public and public-private demonstration projects testing the concept. The role of specialty/subspecialty practices within the PCMH model is described, with a focus on the potential for these practices to serve as a PCMH for a subgroup of patients or, alternatively, as a PCMH "neighbor" that interfaces effectively with PCMH practices. The authors conclude that the model for effective connections between the PCMH and specialty/subspecialty practices requires further development, including the cross-specialty establishment of guidelines and processes regarding referrals, information flow, transitions in care, and accountability. The efforts of the American College of Physicians' Council of Subspecialty Societies PCMH Workgroup to further develop this model are described. The authors encourage involvement from all interested stakeholders to ensure that the issues and challenges identified are addressed through collaboration and consensus based on available evidence.
Topic(s):
Medical Home
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Reference Links: 
View the DOI record for Specialists/subspecialists and the patient-centered medical home
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View the PubMed citation for Specialists/subspecialists and the patient-centered medical home9055
Specialty behavioral health service use among chronically ill medicare advantage patients with substance use problems
Type: Journal Article
Year: 2013
Publication Place: England
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Specialty behavioral health service use among chronically ill medicare advantage patients with substance use problems
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View the PubMed citation for Specialty behavioral health service use among chronically ill medicare advantage patients with substance use problems9056
Specialty care and the patient-centered medical home
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: BACKGROUND: The medical home's success depends, in part, on the degree to which primary care physicians (PCPs) and specialists collaborate to create "medical neighborhoods" based on collective accountability. Such collaboration may require a new equilibrium in chronic disease care, with some of the routine follow-up currently provided by specialists reallocated to PCPs and their medical home teams. OBJECTIVES: To measure the care delivered by specialists for 7 chronic conditions, and to estimate the implications associated with reallocating half among the PCP workforce. RESEARCH DESIGN: Cross-sectional. SUBJECTS: Physicians from the 2007 National Ambulatory Medical Care Survey. MEASURES: We identified adult ambulatory visits for chronic obstructive pulmonary disease/asthma, low back pain, diabetes mellitus, coronary artery disease/congestive heart failure, chronic kidney disease, and depression. We calculated the time spent by specialists in direct and indirect care for established patients with these conditions. We summed individual physician estimates across specialists and converted the total into annual work weeks. After reducing this figure by half, we divided by the number of active PCPs. RESULTS: Most specialty visits (76.8%; 95% confidence interval [CI]: 73.6%-79.7%) were made by established patients. Specialists spent 552,844 (95% CI: 454,660-651,029) and 108,113 (95% CI: 86,103-130,122) cumulative work weeks providing direct and indirect follow-up care, respectively. Reallocating half of this care would generate 3.2 (95% CI: 2.6-3.8) additional work weeks for each PCP. CONCLUSIONS: The cumulative time spent by specialists in routine chronic disease follow-up is nontrivial. Reallocation of this care to PCP-directed medical homes may require multidimensional efforts to expand the primary care workforce.
Topic(s):
Medical Home
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9057
Specialty care medical homes for people with severe, persistent mental disorders
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: The patient-centered medical home concept is central to discussions about the reform of the health care delivery system. Most descriptions of the concept assume that a primary care practice would serve as the hub of the medical home. However, for people with severe and persistent mental disorders, specialty health care settings serve as the principal point of contact with the health care system. For them, a patient-centered medical home in a specialty setting would be the most expedient way to address their urgent health care needs. Among other issues, implementing this idea would mean reimbursement strategies to support the integration and coordination of primary care in specialty settings.
Topic(s):
Financing & Sustainability
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, Medical Home
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, Healthcare Policy
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Reference Links:
View the DOI record for Specialty care medical homes for people with severe, persistent mental disorders
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View the PubMed citation for Specialty care medical homes for people with severe, persistent mental disorders9058
Specialty Physician Designation in Referrals from a Vertically Integrated PCMH
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% (P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.
Topic(s):
Medical Home
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Reference Links:
View the DOI record for Specialty Physician Designation in Referrals from a Vertically Integrated PCMH
View DOI Record
View the PubMed citation for Specialty Physician Designation in Referrals from a Vertically Integrated PCMH9059
Specialty Physician Designation in Referrals from a Vertically Integrated PCMH
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% (P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.
Topic(s):
Medical Home
See topic collection
Reference Links:
View the DOI record for Specialty Physician Designation in Referrals from a Vertically Integrated PCMH
View DOI Record
View the PubMed citation for Specialty Physician Designation in Referrals from a Vertically Integrated PCMH