Literature Collection

12501

Validation of a screening risk index for serious prescription opioid-induced respiratory depression or overdose in a US commercial health plan claims database

Type: Journal Article

Authors: Barbara K. Zedler, William B. Saunders, Andrew R. Joyce, Catherine C. Vick, E. L. Murrelle

Year: 2018

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12502

Validation of an audio computer-assisted self-interview (ACASI) version of the alcohol, smoking and substance involvement screening test (ASSIST) in primary care patients

Type: Journal Article

Authors: J. McNeely, S. M. Strauss, J. Rotrosen, A. Ramautar, M. N. Gourevitch

Year: 2016

Publication Place: England

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12503

Validation of an Expanded Measure of Integrated Care Provider Fidelity: PPAQ-2

Type: Journal Article

Authors: G. P. Beehler, J. S. Funderburk, P. R. King, K. Possemato, J. A. Maddoux, W. R. Goldstein, M. Wade

Year: 2019

Publication Place: United States

Abstract: This study aimed to validate the factor structure of the expanded Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ-2), which is designed to assess provider fidelity to both the Primary Care Behavioral Health (PCBH) and collaborative care management (CCM) models of integrated primary care. Two-hundred fifty-three integrated care providers completed self-reports of professional background, perceptions of clinic integration and related practice barriers, and the PPAQ-2. Confirmatory factor analyses were conducted to assess the theorized factor structure and criterion validity was assessed through correlational analysis. Factor analyses demonstrated adequate fit with the data and acceptable to excellent composite reliabilities across five PCBH domains and five CCM domains. Validity was demonstrated by correlations between adherence scores and measures of clinic integration and barriers to fidelity. The PPAQ-2 is a psychometrically sound measure that can be used in future integrated care dismantling studies to identify provider behaviors that best predict patient outcomes.

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12504

Validation of an Expanded Measure of Integrated Care Provider Fidelity: PPAQ-2

Type: Journal Article

Authors: G. P. Beehler, J. S. Funderburk, P. R. King, K. Possemato, J. A. Maddoux, W. R. Goldstein, M. Wade

Year: 2020

Publication Place: United States

Abstract: This study aimed to validate the factor structure of the expanded Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ-2), which is designed to assess provider fidelity to both the Primary Care Behavioral Health (PCBH) and collaborative care management (CCM) models of integrated primary care. Two-hundred fifty-three integrated care providers completed self-reports of professional background, perceptions of clinic integration and related practice barriers, and the PPAQ-2. Confirmatory factor analyses were conducted to assess the theorized factor structure and criterion validity was assessed through correlational analysis. Factor analyses demonstrated adequate fit with the data and acceptable to excellent composite reliabilities across five PCBH domains and five CCM domains. Validity was demonstrated by correlations between adherence scores and measures of clinic integration and barriers to fidelity. The PPAQ-2 is a psychometrically sound measure that can be used in future integrated care dismantling studies to identify provider behaviors that best predict patient outcomes.

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12505

Validation of an Expanded Measure of Integrated Care Provider Fidelity: PPAQ-2

Type: Journal Article

Authors: G. P. Beehler, J. S. Funderburk, P. R. King, K. Possemato, J. A. Maddoux, W. R. Goldstein, M. Wade

Year: 2020

Publication Place: United States

Abstract: This study aimed to validate the factor structure of the expanded Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ-2), which is designed to assess provider fidelity to both the Primary Care Behavioral Health (PCBH) and collaborative care management (CCM) models of integrated primary care. Two-hundred fifty-three integrated care providers completed self-reports of professional background, perceptions of clinic integration and related practice barriers, and the PPAQ-2. Confirmatory factor analyses were conducted to assess the theorized factor structure and criterion validity was assessed through correlational analysis. Factor analyses demonstrated adequate fit with the data and acceptable to excellent composite reliabilities across five PCBH domains and five CCM domains. Validity was demonstrated by correlations between adherence scores and measures of clinic integration and barriers to fidelity. The PPAQ-2 is a psychometrically sound measure that can be used in future integrated care dismantling studies to identify provider behaviors that best predict patient outcomes.

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12506

Validation of the "problematic use of narcotics" (PUN) screening test for drug using adolescents

Type: Journal Article

Authors: K. Okulicz-Kozaryn, J. Sieroslawski

Year: 2007

Publication Place: England

Abstract: The aim of the study was to examine psychometric properties of the PUN screening test concerning illicit drug problem use by adolescents. The criterion standard for the test's validity was a diagnostic interview conducted by trained specialists. Respondents were reached by snowball sampling in 58 randomly chosen Polish local communities. A total of 1344 adolescent (37% female) aged 13 to 18 years, who used any illicit drug at least once in the past 12 months, participated. The majority (89%) had no contacts with any drug therapy facilities. 41% were diagnosed as occasional drug users and 59% as problematic users or dependents. Logistic regression analysis showed that 10 out of the basic set of 25 test items were most powerful in differentiating occasional and problematic users. A test score of 2 or higher was optimal for identifying problem drug use (sensitivity: 0.88, specificity: 0.79, PPV: 0.86, NPV: 0.81). Validity was not affected by age or sex. These results confirmed the PUN test potential as a brief screening tool.

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12507

Validation of the diagnosis of autism in general practitioner records

Type: Journal Article

Authors: E. Fombonne, L. Heavey, L. Smeeth, L. C. Rodrigues, C. Cook, P. G. Smith, L. Meng, A. J. Hall

Year: 2004

Publication Place: England

Abstract: BACKGROUND: We report on the validity of the computerized diagnoses of autism in a large case-control study investigating the possible association between autism and the measles, mumps and rubella vaccine in the UK using the General Practitioner Research Database (GPRD). We examined anonymized copies of all relevant available clinical reports, including general practitioners' (GP) notes, consultant, speech therapy and educational psychologists reports, on 318 subjects born between 1973 and 1997 with a diagnosis of autism or a related disorder recorded in their electronic general practice record. METHODS: Data were abstracted to a case validation form allowing for the identification of developmental symptoms relevant to the diagnosis of pervasive developmental disorders (PDDs). Information on other background clinical and familial features was also abstracted. A subset of 50 notes was coded independently by 2 raters to derive reliability estimates for key clinical characteristics. RESULTS: For 294 subjects (92.5%) the diagnosis of PDD was confirmed after review of the records. Of these, 180 subjects (61.2%) fulfilled criteria for autistic disorder. The mean age at first recording of a PDD diagnosis in the GPRD database was 6.3 years (SD = 4.6). Consistent with previous estimates, the proportion of subjects experiencing regression in the course of their development was 19%. Inter-rater reliability for the presence of a PDD diagnosis was good (kappa =.73), and agreement on clinical features such as regression, age of parental recognition of first symptoms, language delay and presence of epilepsy was also good (kappas ranging from.56 to 1.0). CONCLUSIONS: This study provides evidence that the positive predictive value of a diagnosis of autism recorded in the GPRD is high.

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12508

Validation of the revised Problems Assessment for Substance Using Psychiatric Patients

Type: Journal Article

Authors: Paula C. Vincent, Clara M. Bradizza, Kate B. Carey, Stephen A. Maisto, Paul R. Stasiewicz, Gerard J. Connors, Nicole D. Mercer

Year: 2011

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12509

Validation of the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R)

Type: Journal Article

Authors: S. F. Butler, K. Fernandez, C. Benoit, S. H. Budman, R. N. Jamison

Year: 2008

Publication Place: United States

Abstract: UNLABELLED: The original Screener and Opioid Assessment for Patients with Pain (SOAPP) is a conceptually derived self-report questionnaire designed to predict aberrant medication-related behaviors among chronic pain patients considered for long-term opioid therapy. The purpose of this study was to develop and validate an empirically derived version of the SOAPP (SOAPP-R) that addresses some limitations of the original SOAPP. In successive steps, items were reduced from an initial pool of 142 to a 97-item beta version. The beta version was administered to 283 chronic pain patients receiving long-term opioid therapy. Items were evaluated based on data collected at follow-up, including correlation with the Aberrant Drug Behavior Index (ADBI), derived from interview data, physician ratings, and urine toxicology screens. Twenty-four items were retained and comprise the final SOAPP-R. Coefficient alpha was .88, and receiver operating characteristics curve analysis yielded an area under the curve of .81 (P < .001). A cutoff score of 18 showed adequate sensitivity (.81) and specificity (.68). The obtained psychometrics, along with the use of a predictive criterion that goes beyond self-report, suggest that the SOAPP-R is an improvement over the original version in screening risk potential for aberrant medication-related behavior among persons with chronic pain. PERSPECTIVE: There is a need for a screener for abuse risk in patients prescribed opioids for pain. This study presents a revised version of the SOAPP-R that is empirically derived with good reliability and validity but is less susceptible to overt deception than the original SOAPP version 1.

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12510

Validity of Retrospective Pretest Methodology

Type: Report

Authors: A. Blount

Year: 2008

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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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12511

Validity of self-reported substance use: research setting versus primary health care setting

Type: Journal Article

Authors: P. Khalili, A. E. Nadimi, H. R. Baradaran, L. Janani, A. Rahimi-Movaghar, Z. Rajabi, A. Rahmani, Z. Hojati, K. Khalagi, S. A. Motevalian

Year: 2021

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12512

Value and Performance of Accountable Care Organizations: a Cost-Minimization Analysis

Type: Journal Article

Authors: S. Parasrampuria, A. H. Oakes, S. S. Wu, M. A. Parikh, W. V. Padula

Year: 2018

Publication Place: England

Abstract: OBJECTIVES: Determine the relationship between quality of an accountable care organization (ACO) and its long-term reduction in healthcare costs. METHODS: We conducted a cost minimization analysis. Using Centers for Medicare and Medicaid cost and quality data, we calculated weighted composite quality scores for each ACO and organization-level cost savings. We used Markov modeling to compute the probability that an ACO transitioned between different quality levels in successive years. Considering a health-systems perspective with costs discounted at 3 percent, we conducted 10,000 Monte Carlo simulations to project long-term cost savings by quality level over a 10-year period. We compared the change in per-member expenditures of Pioneer (early-adopters) ACOs versus Medicare Shared Savings Program (MSSP) ACOs to assess the impact of coordination of care, the main mechanism for cost savings. RESULTS: Overall, Pioneer ACOs saved USD 641.24 per beneficiary and MSSP ACOs saved USD 535.59 per beneficiary. By quality level: (a) high quality organizations saved the most money (Pioneer: USD 459; MSSP: USD 816); (b) medium quality saved some money (Pioneer: USD 222; MSSP: USD 105); and (c) low quality suffered financial losses (Pioneer: USD -40; MSSP: USD -386). CONCLUSIONS: Within the existing fee-for-service healthcare model, ACOs are a mechanism for decreasing costs by improving quality of care. Higher quality organizations incorporate greater levels of coordination of care, which is associated with greater cost savings. Pioneer ACOs have the highest level of integration of services; hence, they save the most money.

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12513

Value and Performance of Accountable Care Organizations: a Cost-Minimization Analysis

Type: Journal Article

Authors: S. Parasrampuria, A. H. Oakes, S. S. Wu, M. A. Parikh, W. V. Padula

Year: 2018

Publication Place: England

Abstract: OBJECTIVES: Determine the relationship between quality of an accountable care organization (ACO) and its long-term reduction in healthcare costs. METHODS: We conducted a cost minimization analysis. Using Centers for Medicare and Medicaid cost and quality data, we calculated weighted composite quality scores for each ACO and organization-level cost savings. We used Markov modeling to compute the probability that an ACO transitioned between different quality levels in successive years. Considering a health-systems perspective with costs discounted at 3 percent, we conducted 10,000 Monte Carlo simulations to project long-term cost savings by quality level over a 10-year period. We compared the change in per-member expenditures of Pioneer (early-adopters) ACOs versus Medicare Shared Savings Program (MSSP) ACOs to assess the impact of coordination of care, the main mechanism for cost savings. RESULTS: Overall, Pioneer ACOs saved USD 641.24 per beneficiary and MSSP ACOs saved USD 535.59 per beneficiary. By quality level: (a) high quality organizations saved the most money (Pioneer: USD 459; MSSP: USD 816); (b) medium quality saved some money (Pioneer: USD 222; MSSP: USD 105); and (c) low quality suffered financial losses (Pioneer: USD -40; MSSP: USD -386). CONCLUSIONS: Within the existing fee-for-service healthcare model, ACOs are a mechanism for decreasing costs by improving quality of care. Higher quality organizations incorporate greater levels of coordination of care, which is associated with greater cost savings. Pioneer ACOs have the highest level of integration of services; hence, they save the most money.

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12514

Value of using artificial intelligence derived clusters by health and social care need in primary care: A qualitative interview study with patients living with multiple long-term conditions, carers and health care professionals

Type: Journal Article

Authors: S. Holt, G. Simpson, M. Santer, H. Everitt, A. Farmer, K. Zhou, Z. Qian, F. Davies, H. Dambha-Miller, L. Morrison

Year: 2025

Abstract:

BACKGROUND: People living with MLTCs attending primary care often have unmet social care needs (SCNs), which can be challenging to identify and address. Artificial intelligence (AI) derived clusters could help to identify patients at risk of SCNs. Evidence is needed on views about the use of AI-derived clusters, to inform acceptable and meaningful implementation within interventions. METHOD: Qualitative semi-structured interviews (online and telephone), including a description of AI-derived clusters and a tailored vignette, with 24 people living with MLTCs and 20 people involved in the care of MLTCs (carers and health care professionals). Interviews were analysed using Reflexive and Codebook Thematic Analysis. RESULTS: Primary care was viewed as an appropriate place to have conversations about SCNs. However, participants felt health care professionals lack capacity to have these conversations and to identify support. AI was perceived as a tool that could potentially increase capacity but only when supplemented with effective, clinical conversations. Interventions harnessing AI should be brief, be easy to use and remain relevant over time, to ensure no additional burden on clinical capacity. Interventions must allow flexibility to be used by multidisciplinary teams within primary care, frame messages positively and facilitate conversations that remain patient centered. CONCLUSION: Our findings suggest that implementing AI-derived clusters to identify and support SCNs in primary care is perceived as valuable and can be used as a tool to inform and prioritse effective clinical conversations. But concerns must be addressed, including how AI-derived clusters can be used in a way that considers personal context.

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12515

Value-Based Care Alone Won't Reduce Health Spending and Improve Patient Outcomes

Type: Report

Authors: David Bailey

Year: 2017

Publication Place: Boston, MA

Topic(s):

,

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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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12516

Value-based financially sustainable behavioral health components in patient-centered medical homes

Type: Journal Article

Authors: R. G. Kathol, F. DeGruy, B. L. Rollman

Year: 2014

Publication Place: United States

Abstract: Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integrate behavioral health services into their structure. Yet in today's health care environment, the incorporation of behavioral services into primary care is exceptional rather than usual practice. In this article, we discuss the components considered necessary to provide sustainable, value-added integrated behavioral health care in the PCMH. These components are to: (1) combine medical and behavioral benefits into one payment pool; (2) target complex patients for priority behavioral health care; (3) use proactive onsite behavioral "teams;" (4) match behavioral professional expertise to the need for treatment escalation inherent in stepped care; (5) define, measure, and systematically pursue desired outcomes; (6) apply evidence-based behavioral treatments; and (7) use cross-disciplinary care managers in assisting the most complicated and vulnerable. By adopting these 7 components, PCHMs will augment their ability to achieve improved health in their patients at lower cost in a setting that enhances ease of access to commonly needed services.

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12517

Value-Based Payment As Part Of A Broader Strategy To Address Opioid Addiction Crisis

Type: Report

Authors: Joshua Barrett, Mingjie Li, Brigitta Spaeth-Rublee, Harold A. Pincus

Year: 2017

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,

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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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12518

Value-based payment in implementing evidence-based care: the Mental Health Integration Program in Washington state

Type: Journal Article

Authors: Y. Bao, T. G. McGuire, Y. F. Chan, A. A. Eggman, A. M. Ryan, M. L. Bruce, H. A. Pincus, E. Hafer, J. Unutzer

Year: 2017

Publication Place: United States

Abstract: OBJECTIVES: To assess the role of value-based payment (VBP) in improving fidelity and patient outcomes in community implementation of an evidence-based mental health intervention, the Collaborative Care Model (CCM). STUDY DESIGN: Retrospective study based on a natural experiment. METHODS: We used the clinical tracking data of 1806 adult patients enrolled in a large implementation of the CCM in community health clinics in Washington state. VBP was initiated in year 2 of the program, creating a natural experiment. We compared implementation fidelity (measured by 3 process-of-care elements of the CCM) between patient-months exposed to VBP and patient-months not exposed to VBP. A series of regressions were estimated to check robustness of findings. We estimated a Cox proportional hazard model to assess the effect of VBP on time to achieving clinically significant improvement in depression (measured based on changes in depression symptom scores over time). RESULTS: Estimated marginal effects of VBP on fidelity ranged from 9% to 30% of the level of fidelity had there been no exposure to VBP (P <.05 for every fidelity measure). Improvement in fidelity in response to VBP was greater among providers with a larger patient panel and among providers with a lower level of fidelity at baseline. Exposure to VBP was associated with an adjusted hazard ratio of 1.45 (95% confidence interval, 1.04-2.03) for achieving clinically significant improvement in depression. CONCLUSIONS: VBP improved fidelity to key elements of the CCM, both directly incentivized and not explicitly incentivized by the VBP, and improved patient depression outcomes.

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12519

Value-based pricing of cognitive behavioral therapy for depression in primary care: an economic evaluation

Type: Journal Article

Authors: A. Gandjour

Year: 2024

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12520

Value-Based Proposition of an Adapted Integrated Care Telehealth Service for Accountable Care Organization Members

Type: Journal Article

Authors: J. Shore, M. Waugh, J. Harding, G. Roupas, N. Pepi, P. Ryan

Year: 2024

Abstract:

The authors describe a real-world application of virtually integrated primary and behavioral health care implemented within an accountable care organization (ACO) system. Cost-of-care data from before and after a 6-month intervention were analyzed for 121 Medicaid and Child Health Plan Plus ACO members. The intervention was associated with a significant shift in the distribution of health care costs, from inpatient and emergency care to outpatient and preventive care. The program demonstrates a flexible and replicable approach to integration that can help expand effective primary care.

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