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Opioids & SU
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).
12779 Results
10361
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
See topic collection
10362
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
See topic collection
, Medical Home
See topic collection
, Healthcare Policy
See topic collection
Reference Links:
View the DOI record for Specialty care medical homes for people with severe, persistent mental disorders
View DOI Record
View the PubMed citation for Specialty care medical homes for people with severe, persistent mental disorders
10363
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
10364
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
10367
Specificity of personality relationships to particular forms of concurrent substance use among methadone maintenance therapy clients
Type:
Journal Article
Year:
2019
Publication Place:
England
Topic(s):
Opioids & Substance Use
See topic collection
, Healthcare Disparities
See topic collection
10368
Spending money to make change: Association of methamphetamine abstinence and voucher spending among contingency management pilot participants in South Africa
Type:
Journal Article
Year:
2020
Topic(s):
Opioids & Substance Use
See topic collection
, Financing & Sustainability
See topic collection
10373
St. Louis Initiative for Integrated Care Excellence (SLI(2)CE): integrated-collaborative care on a large scale model
Type:
Journal Article
Year:
2010
Publication Place:
United States
Topic(s):
General Literature
See topic collection
Reference Links:
View the DOI record for St. Louis Initiative for Integrated Care Excellence (SLI(2)CE): integrated-collaborative care on a large scale model
View DOI Record
View the PubMed citation for St. Louis Initiative for Integrated Care Excellence (SLI(2)CE): integrated-collaborative care on a large scale model
10374
Stabilizing the Mother-Infant Dyad for Better Outcomes from OB to FM: Caring for Patients with Perinatal Opioid Use Disorder through the 4th Trimester
Type:
Journal Article
Year:
2018
Publication Place:
United States
Topic(s):
Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
10375
Staff and Organizational Capacity in the Implementation of Coordinated Care: an Examination of 10 Behavioral Health Agencies in Rural Communities
Type:
Journal Article
Year:
2020
Publication Place:
United States
Abstract:
Providing primary care services in behavioral health settings has become more common and necessary given the needs of individuals with serious mental illness (SMI). In this exploratory study, we developed a survey to assess agency and professional staff and practitioner capacity for coordinated care. The survey provides a feedback mechanism for agencies to target staff and organizational needs related to building capacity to provide coordinated care. Logistic regressions compared differences in 24 dimensions of coordinated care specifically comparing capacity based on professional role (behavioral health and medical), model of coordination (co-located and fully integrated), and time of model adoption (early and late adopters). Findings indicated that all three were significant predictors of capacity in multiple dimensions suggesting the need for training and planning around inter-professional and inter-agency coordination.
Topic(s):
Education & Workforce
See topic collection
, Healthcare Disparities
See topic collection
10377
Staff perceptions implementing interprofessional team-based behavioural healthcare
Type:
Journal Article
Year:
2017
Publication Place:
England
Abstract:
The US Veterans Health Administration (VHA) in 2013 mandated a nationwide implementation of interprofessional team-based care in the general mental health setting and officially endorsed the collaborative care model in 2015 to guide the coordinated and anticipatory care to be delivered by these teams. Front-line clinic staff are major stakeholders whose practices are most directly affected by this implementation and may or may not view teams as useful or feasible for their practice. Our objective was to examine their perspectives on delivering team-to-patient care in order to understand what system-level efforts can best support the transition to such care from the more conventional provider-to-patient care. We conducted 14 semi-structured interviews with staff from general mental health clinics across three different VHA medical facilities. The interview questions focused on asking how care is organised and delivered at their clinic, their experiences in collaborating with other staff, and how the clinic handles changes. Four recurrent themes were identified: navigating workplace supervision, organisation, and role structures; continuing professional growth and relationships; delivering patient-focused care through education and connection to resources; and utilising information technology for communication and panel-based management. Quality improvement efforts were rarely discussed during the interviews. Our results indicate that staff's endorsement of the implementation of interprofessional care teams in general mental health settings may be strengthened through associated efforts targeted at enhancing their experiences aligned to these emergent themes.
Topic(s):
Education & Workforce
See topic collection
Reference Links:
View the DOI record for Staff perceptions implementing interprofessional team-based behavioural healthcare
View DOI Record
View the PubMed citation for Staff perceptions implementing interprofessional team-based behavioural healthcare
10378
Staff Perceptions of Substance Use Disorder Treatment in VA Primary Care-Mental Health Integrated Clinics
Type:
Journal Article
Year:
2016
Publication Place:
United States
Abstract:
INTRODUCTION: Guidelines recommend that substance use disorder (SUD) treatment be available in primary care-mental health integrated clinics, which offer mental and behavioral health assessment and treatment in the primary care setting. Despite this recommendation it is unclear what barriers and facilitators exist to SUD treatment being provided in that setting. This work sought to understand current SUD services in such integrated clinics, explore other services may that be appropriate, and identify barriers to such services. METHODS: We conducted qualitative interviews with 23 staff members from integrated clinics at 6 Veterans Affairs medical centers. We transcribed interviews and performed thematic analysis to identify emergent themes. RESULTS: We identified seven themes affecting staff experience and ability to provide SUD services in the integrated clinic: clinical effectiveness, clinical requirements, regulatory requirements, program goals, proximity of the integrated clinic and SUD services, training on substance use disorder, and role specialization. CONCLUSIONS: VA primary care-mental health integrated clinic staff members do not currently view SUD treatment as the focus of their work, but are open to offering SUD treatment including brief psychological interventions or medication. Several barriers to providing SUD treatment were identified, including the need for additional staff training around appropriate interventions for the integrated clinic setting, additional staffing and space, and a structured implementation strategy to promote the use of SUD treatments.
Topic(s):
Opioids & Substance Use
See topic collection
Reference Links:
View the PubMed citation for Staff Perceptions of Substance Use Disorder Treatment in VA Primary Care-Mental Health Integrated Clinics