scholarly journals Integrated care models and behavioral health care utilization: Quasi‐experimental evidence from Medicaid health homes

2020 ◽  
Vol 29 (9) ◽  
pp. 1086-1097 ◽  
Author(s):  
Chandler McClellan ◽  
Johanna Catherine Maclean ◽  
Brendan Saloner ◽  
Emma E. McGinty ◽  
Michael F. Pesko
2017 ◽  
Vol 28 (5) ◽  
pp. 708-722 ◽  
Author(s):  
Lauren Munro ◽  
Zack Marshall ◽  
Greta Bauer ◽  
Rebecca Hammond ◽  
Caleb Nault ◽  
...  

2020 ◽  
Vol 32 (5) ◽  
pp. 419-427
Author(s):  
Deane E. Aikins ◽  
Robert H. Pietrzak ◽  
Joseph C. Geraci ◽  
Todd Benham ◽  
Paul Morrissey ◽  
...  

2015 ◽  
Vol 36 (4) ◽  
pp. 407-412 ◽  
Author(s):  
Susan L. Calcaterra ◽  
Angela Keniston ◽  
Joshua Blum ◽  
Tessa Crume ◽  
Ingrid A. Binswanger

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 342-347
Author(s):  
Jennifer L McDonald ◽  
Michelle L Ganulin ◽  
Michael N Dretsch ◽  
Maura R Taylor ◽  
Oscar A Cabrera

ABSTRACT Introduction The goal of the present study was to characterize behavioral health rates, behavioral health care utilization, loneliness, and perceived prejudice and support among sexual minority soldiers. Materials and Methods Cross-sectional survey data were obtained from 640 active-duty U.S. soldiers enrolled in an academic training institute who provided information on their sexual orientation. Survey topics included demographics, behavioral health, behavioral health care utilization, and mitigating factors (eg, perceived prejudice, perceived support, and loneliness). Chi-square analyses were utilized to determine any differences between groups for behavioral health rates and behavioral health care utilization. Robust regression was used for analysis of self-reported loneliness. Results A higher proportion of lesbian, gay, bisexual (LGB) soldiers than heterosexual soldiers screened positive for anxiety, post-traumatic stress disorder, and suicidality. No between-group differences in behavioral health care utilization were found; however, a higher proportion of LGB soldiers sought help from military family life counselors. No between-group differences for loneliness were found. Finally, perceived prejudice was higher for LGB soldiers and perceived support was lower. Conclusion Organizational barriers, such as perceived prejudice and lack of support, appear to still exist for sexual minority soldiers. Increasing organizational support and implementing training and education for health care providers in order to better support the LGB soldier community may mitigate these barriers.


2018 ◽  
Vol 36 (5) ◽  
pp. 408-416
Author(s):  
Heather R. Britt ◽  
Meghan M. JaKa ◽  
Karl M. Fernstrom ◽  
Paige E. Bingham ◽  
Anne E. Betzner ◽  
...  

Whole-person care is a new paradigm for serious illness, but few programs have been robustly studied. We sought to test the effect of LifeCourse (LC), a person-centered program for patients living with serious illness, on health-care utilization, care experience, and quality of life, employing a quasi-experimental design with a Usual Care (UC) comparison group. The study was conducted 2012 to 2017 at an upper-Midwest not-for-profit health-care system with outcomes measured every 3 months until the end of life. Enrolled patients (N = 903) were estimated to be within 3 years of end of life and diagnosed with 1+ serious illness. Exclusion criteria included hospice enrollment at time of screening or active dying. Community health workers (CHWs) delivered standardized monthly 1-hour home visits based on palliative care guidelines and motivational interviewing to promote patients’ physical, psychosocial, and financial well-being. Primary outcomes included health-care utilization and patient- and caregiver-experience and quality of life. Patients were elderly (LC 74, UC 78 years) and primarily non-Hispanic, white, living at home with cardiovascular disease as the primary diagnosis (LC 69%, UC 57%). A higher proportion of LC patients completed advance directives (N = 173, 38%) than UC patients (N = 66, 15%; P < .001). LifeCourse patients who died spent more days in hospice (88 ± 191 days) compared to UC patients (44 ± 71 days; P = .018). LifeCourse patients reported greater improvements than UC in communication as part of the care experience ( P = .016). Implementation of person-centered programs delivered by CHWs is feasible; inexpensive upstream expansion of palliative care models can yield benefits for patients and caregivers. Trial Registration: Trial NCT01746446 was registered on November 27, 2012 at ClinicalTrials.gov .


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