Literature Collection

9981

The mediation and moderation effect of social support on the relationship between opioid misuse and suicide attempts among native American youth in New Mexico: 2009‑2019 Youth Risk Resiliency Survey (NM‑YRRS)

Type: Journal Article

Authors: Daniel Opoku Agyemang, Erin Fanning Madden, Kevin English, Kamilla L. Venner, Rod Handy, Tejinder Pal Singh, Fares Qeadan

Year: 2022

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9982

The medical home and integrated behavioral health

Type: Journal Article

Authors: J. M. Foy

Year: 2015

Publication Place: United States

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9983

The medical home and integrated behavioral health: Advancing the policy agenda

Type: Journal Article

Authors: J. Ader, C. J. Stille, D. Keller, B. F. Miller, M. S. Barr, J. M. Perrin

Year: 2015

Publication Place: United States

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9984

The medical home and mental health services in children and youth with special health care needs

Type: Journal Article

Authors: Jessica E. Rast, Anne M. Roux, Gabrielle Connor, Tobechukwu H. Ezeh, Lindsay Shea, Renee M. Turchi, Paul T. Shattuck

Year: 2023

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9985

The medical home as a mediator of the relation between mental health symptoms and family burden among children with special health care needs

Type: Journal Article

Authors: R. M. Ghandour, D. F. Perry, M. D. Kogan, B. B. Strickland

Year: 2011

Publication Place: United States

Abstract: OBJECTIVE: This study explores the role of medical home as a mediator of the relationship between emotional and behavioral difficulties among CSHCN and financial- and employment-related burden experienced by their families. METHODS: Data were obtained from the 2005-2006 NS-CSHCN, a nationally representative cross-sectional survey of 40 465 CSHCN. Family burden was measured using parent-reported financial problems and changes in family member employment resulting from the child's needs. Emotional and behavioral symptoms were reported by parents using 3 binary items capturing difficulty with depression, anxiety, disordered eating, and emotional or behavior problems. Medical home was measured according to the framework of the American Academy of Pediatrics. Bivariate and multivariate analyses were used to explore the role of medical home in the relation between mental health symptoms and family burden. RESULTS: A smaller proportion of CSHCN with emotional or behavioral difficulties had a medical home or related components compared to CSHCN generally, and a greater proportion of their families experienced burdens. Multivariate analyses showed that the mediated effect of care coordination on the relation between emotional or behavioral symptoms and family burden explained 18% to 35% of the total effect of these symptoms on financial problems and employment changes. Overall medical home access explained 16% to 28% of the total effect of symptoms on burden. CONCLUSIONS: Medical home access, and care coordination in particular, may partially mediate the relation between emotional and behavioral symptoms and financial hardship. Future efforts to implement the medical home model may benefit from an increased focus on care coordination as a means of reducing these burdens.

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9986

The medical home functions of primary care practices that care for adults with psychological distress: a cross-sectional study

Type: Journal Article

Authors: S. Linman, I. Benjenk, J. Chen

Year: 2019

Publication Place: England

Abstract: BACKGROUND: Primary care practices are changing the way that they provide care by increasing their medical home functionality. Medical home functionality can improve access to care and increase patient-centeredness, which is essential for persons with mental health issues. This study aims to explore the degree to which medical home functions have been implemented by primary care practices that care for adults with psychological distress. METHODS: Analysis of the 2015 Medical Expenditure Panel Survey Household Component and Medical Organizations Survey. This unique data set links data from a nationally representative sample of US households to the practices in which they receive primary care. This study focused on adults aged 18 and above. RESULTS: As compared to adults without psychological distress, adults with psychological distress had significantly higher rates of chronic illness and poverty. Adults with psychological distress were more likely to receive care from practices that include advanced practitioners and are non-profit or hospital-based. Multivariate models that were adjusted for patient-level and practice-level characteristics indicated that adults with psychological distress are as likely to receive primary care from practices with medical home functionality, including case management, electronic health records, flexible scheduling, and PCMH certification, as adults without psychological distress. CONCLUSIONS: Practices that care for adults with mental health issues have not been left behind in the transition towards medical home models of primary care. Policy makers should continue to prioritize adults with mental health issues to receive primary care through this model of delivery due to this population's great potential to benefit from improved access and care coordination. TRIAL REGISTRATION: This study does not report the results of a health care intervention on human subject's participants.

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9987

The Medical Home Index: Development and validation of a new practice-level measure of implementation of the Medical Home model

Type: Journal Article

Authors: W. C. Cooley, J. W. McAllister, K. Sherrieb, R. E. Clark

Year: 2003

Publication Place: United States

Abstract: OBJECTIVE: The Medical Home is a clinical practice concept that sets new standards for pediatric primary care. This study describes the development and validation of a tool to measure the Medical Home. METHODOLOGY: The Medical Home Index (MHI) consists of 25 themes arranged among 6 domains of primary care office activity. A national panel of experts on the Medical Home reviewed a prototype of the instrument. Pediatric primary care offices completed the MHI and participated in 90-minute on-site interviews with two of the authors (J.W.M., K.S.). The study examined interrater reliability between the 2 project staff and between the practices and project staff and the internal consistency of MHI domains and themes. RESULTS: On a 100-point scale, 43 practices demonstrated a range of MHI summary scores from 18.9 to 75.4, with a mean of 43.9. Kappa coefficients of interrater reliability between two Center for Medical Home Improvement project staff were above.50 for all 25 themes. Kappa scores comparing each staff member and the practice sites' self-assessment found 80% of the themes at.65 or better for one interviewer (J.W.M.) and 60% of the themes at.65 or better for the second interviewer (K.S.). Intraclass correlation coefficients between the summary scores of the interviewers were.98 and between the scores of the two interviewers and the scores of the practices was.97. The internal consistency reliability standardized alpha coefficients across the 6 domains of the MHI ranged from.81 to.91, and the overall standardized alpha coefficient was.96. CONCLUSIONS: In the sample of practices studied, the MHI was an internally consistent instrument with acceptable reliability and validity for pediatric primary care practices to assess their implementation of the Medical Home concept. Further work is needed to study its correlation with other process and outcome measures and its performance in a wider range of practices.

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9988

The Medical Home Transformation in the Veterans Health Administration: An Evaluation of Early Changes in Primary Care Delivery

Type: Journal Article

Authors: Rachel M. Werner, Anne Canamucio, Judy A. Shea, Gala True

Year: 2014

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9989

The medical home, preventive care screenings, and counseling for children: Evidence from the Medical Expenditure Panel Survey

Type: Journal Article

Authors: M. A. Romaire, J. F. Bell

Year: 2010

Publication Place: United States

Abstract: OBJECTIVE: Little is known about the role of the medical home in promoting essential preventive health care services in the general pediatric population. This study examined associations between having a medical home and receipt of health screenings and anticipatory guidance. METHODS: We conducted a cross-sectional analysis of the 2004-2006 Medical Expenditure Panel Survey (MEPS). Our sample included 21 055 children aged 0 to 17 years who visited a health care provider in the year prior to the survey. A binary indicator of the medical home was developed from 22 questions in MEPS, reflecting 4 of the 7 American Academy of Pediatrics' recommended components of the medical home: accessible, family-centered, comprehensive, and compassionate care. Multivariable logistic regression was used to examine the association between the medical home and receipt of specific health screenings and anticipatory guidance, controlling for confounding variables. RESULTS: Approximately 49% of our study sample has a medical home. The medical home, defined when the usual source of care is a person or facility, is significantly associated with 3 health screenings (ie, weight, height, and blood pressure) and several anticipatory guidance topics (ie, advice about dental checkups, diet, exercise, car and bike safety), with odds ratios ranging from 1.26 to 1.54. CONCLUSIONS: The medical home is associated with increased odds of children receiving some health screenings and anticipatory guidance. The medical home may provide an opportunity to improve the delivery of these services for children.

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9990

The medical home: A model for 21st century health care

Type: Web Resource

Authors: M . Y. Mann

Year: 2009

Publication Place: Arlington, VA

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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.

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9991

The medical home: Growing evidence to support a new approach to primary care

Type: Journal Article

Authors: T. C. Rosenthal

Year: 2008

Publication Place: United States

Abstract: INTRODUCTION: A medical home is a patient-centered, multifaceted source of personal primary health care. It is based on a relationship between the patient and physician, formed to improve the patient's health across a continuum of referrals and services. Primary care organizations, including the American Board of Family Medicine, have promoted the concept as an answer to government agencies seeking political solutions that make quality health care affordable and accessible to all Americans. METHODS: Standard literature databases, including PubMed, and Internet sites of numerous professional associations, government agencies, business groups, and private health organizations identified over 200 references, reports, and books evaluating the medical home and patient-centered primary care. FINDINGS: Evaluations of several patient-centered medical home models corroborate earlier findings of improved outcomes and satisfaction. The peer-reviewed literature documents improved quality, reduced errors, and increased satisfaction when patients identify with a primary care medical home. Patient autonomy and choice also contributes to satisfaction. Although industry has funded case management models demonstrating value superior to traditional fee-for-service reimbursement adoption of the medical home as a basis for medical care in the United States, delivery will require effort on the part of providers and incentives to support activities outside of the traditional face-to-face office visit. CONCLUSIONS: Evidence from multiple settings and several countries supports the ability of medical homes to advance societal health. A combination of fee-for-service, case management fees, and quality outcome incentives effectively drive higher standards in patient experience and outcomes. Community/provider boards may be required to safeguard the public interest.

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9992

The medical home: Health care access and impact for children and youth in the United States

Type: Journal Article

Authors: B. B. Strickland, J. R. Jones, R. M. Ghandour, M. D. Kogan, P. W. Newacheck

Year: 2011

Publication Place: United States

Abstract: OBJECTIVE: The medical home concept encompasses the elements of pediatric care considered essential for all children. We describe here the characteristics of children with medical homes and the relationship between presence of a medical home and selected health care outcomes by using new data from the 2007 National Survey of Children's Health (NSCH). METHODS: We used a medical home measure comprising 5 components: having a usual source of care; having a personal physician or nurse; receiving all needed referrals for specialty care; receiving help as needed in coordinating health and health-related care; and receiving family-centered care. A total of 83 448 children aged 1 to 17 years had valid data for all applicable medical home components. The NSCH is a random-digit-dial population-based telephone survey. RESULTS: In 2007, 56.9% of US children aged 1 to 17 years received care in medical homes. Younger children were more likely to have a medical home than their older counterparts. Substantial racial/ethnic, socioeconomic, and health-related disparities were present. Children who received care in medical homes were less likely to have unmet medical and dental needs and were more likely to have annual preventive medical visits. CONCLUSIONS: Approximately half of the children in the United States have access to all components of a pediatric medical home. Because the medical home is increasingly promoted as the standard for provision of high-quality comprehensive health care, these findings reinforce the need to continue and expand federal, state, and community efforts to ensure that all children have access to this model of care.

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9993

The medical home: Locus of physician formation

Type: Journal Article

Authors: T. P. Daaleman

Year: 2008

Publication Place: United States

Abstract: Family medicine is currently undergoing a transformation and, amid such change, the medical home has emerged as the new polestar. This article examines the medical home through the lens of philosopher Alasdair MacIntyre and offers a perspective, informed by Hubert Dreyfus and Peter Senge, about medical homes as practical sites of formation for family physicians. The intellectual past of family medicine points to contextually sensitive patient care as a practice that is particular to the discipline, with the virtue of "placing patients within contexts over time" as a commonly held virtue. Dreyfus provides a model of knowledge and skill acquisition that is relevant to the training of family physicians in practical wisdom. In this model, there is a continuum from novice to more advanced stages of professional formation that is aided by rules that not only must be learned, but must be applied in greater contextually informed situations. Senge's emphasis on learning organizations-organizations where people are continually learning how to learn together-presents a framework for evaluating the extent to which future medical homes facilitate or retard the formation of family physicians.

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9994

The Medical-Psychiatric Coordinating Physician-Led Model: Team-Based Treatment for Complex Patients

Type: Journal Article

Authors: S. A. Frankel, J. A. Bourgeois, G. Xiong, R. McCarron, J. Han, P. Erdberg

Year: 2014

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9995

The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?

Type: Government Report

Authors: Jill Eden, Katie Maslow, Mai Le, Dan Blazer

Year: 2012

Abstract: At least 5.6 million to 8 million--nearly one in five--older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation.For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. An expert committee assessed the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.

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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.

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9996

The mental health of doctor-shoppers: experience from a patient-led fee-for-service primary care setting

Type: Journal Article

Authors: J. Norton, G. de Roquefeuil, M. David, J. P. Boulenger, K. Ritchie, A. Mann

Year: 2011

Publication Place: Netherlands

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9997

The mental health professions: Workforce supply and demand, issues, and challenges

Type: Journal Article

Authors: W. N. Robiner

Year: 2006

Publication Place: United States

Abstract: The U.S. mental health (MH) workforce is comprised of core disciplines: psychology, psychiatry, social work, psychiatric nursing, and marriage and family therapy. A broader group of practitioners also deserves recognition. Diverse professions provide significant services in a variety of settings, extending the de facto mental health workforce. A tally of key disciplines estimates there are 537,857 MH professionals, or 182 per 100,000 U.S. population. This article provides an overview of the need and demand for mental health services and summarizes the MH professions (e.g., training, educational credentials, workforce estimates). It also discusses a range of challenges confronting MH professionals and the need for greater understanding of the workforce and integration of services. Methodological factors that confound estimates of the magnitude of the MH workforce are reviewed.

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9998

The Mental Health workforce in Texas: A snapshot of the issues

Type: Report

Authors: Hogg Foundation for Mental Health

Year: 2007

Abstract:

Texas is in urgent need of more well-trained and supported mental health professionals. The majority of the state's counties are characterized by a shortage of mental health professionals, with declines in supply in recent years most notably affecting rural areas. Both leaders of Texas state agencies and community healthcare organizations report extensive problems in recruitment and retention and insufficient training capacity. Existing supply gaps in mental health providers are likely to increase as an aging workforce begins to retire and job availability for mental health professions increases. Despite the number of Texas universities offering professional education in mental health fields, insufficient attempts are being made to research and promote organized and widespread recruitment and retention activities. People of color are underrepresented in mental health professions, and Texas appears to be lacking in effective racial and culturally diverse recruitment in the mental health professions. This snapshot of the current state of the Texas mental health workforce provides preliminary information to highlight issues that key stakeholders--professionals, employers, higher education, consumers of services, and licensing boards, among others--must address to assure the availability of a qualified mental health workforce.

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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.

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9999

The mental health/primary care interface in the United States: history, structure, and context

Type: Journal Article

Authors: B. G. Druss

Year: 2002

Publication Place: United States

Abstract: This paper, the first in a series commissioned by NIMH for the "Challenges for the 21st Century: Mental Health Services Research Conference," seeks to provide a broad perspective on the primary care/mental health interface in the United States. The manuscript examines both the care of mental disorders in medical settings, and also the medical care of the seriously medically ill. The first section provides a historical overview of the cycling patterns of growth and retrenchment of primary care medicine during the 20th century, and the how those changes have paralleled the care of mental disorders and the mentally ill. The second section examines the four core features of primary care -first contact, longitudinality, comprehensiveness and coordination -and their implications for these issues. An historical and system-level perspective can provide a crucial step towards improving care on the mental health/primary care interface.

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10000

The Michigan Child Care Collaborative Program: Building a Telepsychiatry Consultation Service

Type: Journal Article

Authors: S. Marcus, N. Malas, R. Dopp, J. Quigley, A. C. Kramer, E. Tengelitsch, P. D. Patel

Year: 2019

Publication Place: United States

Abstract: This column describes the establishment of the Michigan Child Care Collaborative (MC3), a statewide telepsychiatry consultation program that provides support to primary care providers (PCPs) in meeting the mental health needs of youths and perinatal women. The MC3 program provides cost-effective, timely, remote consultation to primary care providers in an effort to address the lack of access and scarcity of resources in child, adolescent, and perinatal psychiatry. Data from 10,445 service requests are summarized. Common diagnoses included attention-deficit hyperactivity disorder, mood disorders, anxiety disorders, and autistic spectrum disorders, with many cases (58%) deemed moderate to severe. Co-occurring psychological trauma was suspected in 9% of service requests. Partnerships, stakeholder roles, PCP engagement, and workflow integration are highlighted as keys to the program's success.

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