scholarly journals Integrating Mental Health into a Primary Care System: A Hybrid Simulation Model

2018 ◽  
pp. 55-63
Author(s):  
Roberto Aringhieri ◽  
Davide Duma ◽  
Francesco Polacchi
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Simulation Model ◽  
Hybrid Simulation ◽  
Primary Care System ◽  
System A ◽  
Care System

scholarly journals Mental Healthcare Delivery in Rural Greece: A 10-year Account of a Mobile Mental Health Unit

2017 ◽  
Vol 08 (04) ◽  
pp. 556-561 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Thiresia Manthopoulou ◽  
Afroditi Gogou ◽  
Venetsanos Mavreas
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Community Mental Health ◽  
Rural Areas ◽  
Catchment Area ◽  
Mental Healthcare ◽  
Community Mental Health Service ◽  
Primary Care System ◽  
Mobile Mental Health ◽  
Care System

ABSTRACTIntroduction: Patients living in rural and remote areas may have limited access to mental healthcare due to lack of facilities and socioeconomic reasons, and this is the case of rural areas in Eastern Europe countries. In Greece, community mental health service delivery in rural areas has been implemented through the development of the Mobile Mental Health Units (MMHUs). Methods: We present a 10-year account of the operation of the MMHU of the prefectures of Ioannina and Thesprotia (MMHU I-T) and report on the impact of the service on mental health delivery in the catchment area. The MMHU I-T is a multidisciplinary community mental health team which delivers services in rural and mountainous areas of Northwest Greece. Results: The MMHU I-T has become an integral part of the local primary care system and is well known to the population of the catchment area. By the end of 2016, the majority of patients (60%) were self-referred or family-referred, compared to 24% in the first 2 years. Currently, the number of active patients is 293 (mean age 63 years, 49.5% are older adults), and the mean caseload for each member of the team is 36.6. A significant proportion of patients (28%) receive care with regular domiciliary visits, and the provision of home-based care was correlated with the age of the patients. Within the first 2 years of operation of the MMHU I-T hospitalizations of treatment, engaged patients were reduced significantly by 30.4%, whereas the treatment engagement rates of patients with psychotic disorders were 67.2% in 5 years. Conclusions: The MMHU I-T and other similar units in Greece are a successful paradigm of a low-cost service which promotes mental health in rural, remote, and deprived areas. This model of care may be informative for clinical practice and health policy given the ongoing recession and health budget cuts. It suggests that rural mental healthcare may be effectively delivered by integrating generic community mental health mobile teams into the primary care system.

scholarly journals Recommendations from primary care providers for integrating mental health in a primary care system in rural Nepal

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Bibhav Acharya ◽  
Jasmine Tenpa ◽  
Poshan Thapa ◽  
Bikash Gauchan ◽  
David Citrin ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Care System ◽  
Rural Nepal ◽  
Care System

scholarly journals Estimating the Costs of Implementing Comprehensive Primary Care: A Narrative Review

2019 ◽  
Vol 6 ◽  
pp. 233339281984248
Author(s):  
Grant R. Martsolf ◽  
Ryan Kandrack ◽  
Mark W. Friedberg ◽  
Brian Briscombe ◽  
Peter S. Hussey ◽  
...  
Keyword(s):  
Primary Care ◽  
Narrative Review ◽  
Fee For Service ◽  
Primary Care System ◽  
High Functioning ◽  
Illness Burden ◽  
Care Practices ◽  
Primary Care Practices ◽  
Limited Generalizability ◽  
Care System

The performance of the any health-care system relies on a high-functioning primary care system. Increasing primary care practices’ adoption of “comprehensive primary care” capabilities might yield meaningful improvements in the quality and efficiency of primary care. However, many comprehensive primary care capabilities, such as care management and coordination, are not compensated via traditional fee-for-service payment. To calculate new payments for these capabilities, policymakers would need estimates of the costs that practices incur when adopting, maintaining, and using the capabilities. We performed a narrative review of the existing literature on the costs of adopting and implementing comprehensive primary care capabilities. These studies have found that practices incur significant costs when adopting and implementing comprehensive primary care capabilities. However, the studies had significant limitations that prevent extensive use of their estimates for payment policy. Particularly, the strongest studies focused on a small numbers of practices in specific geographic areas and the concepts and methods used to assess costs varied greatly across the studies. Furthermore, none of the studies in our review attempted to estimate differences in costs across practices with patients at varying levels of complexity and illness burden which is important for risk-adjusting payments to practices. Therefore, due to the heterogeneous designs and limited generalizability of published studies highlight the need for additional research, especially if payers wish to link their financial support for comprehensive primary care capabilities to the costs of these capabilities for primary care practices.

Do We Need More Pediatricians? Effect of Group Practice

PEDIATRICS ◽  
1973 ◽  
Vol 51 (4) ◽  
pp. 754-755
Author(s):  
Harvey Klevit
Keyword(s):  
Primary Care ◽  
Health Plan ◽  
Statistical Data ◽  
Group Practice ◽  
Primary Care System ◽  
Manpower Shortage ◽  
Care System

We appreciate being cited as a model efficient primary care system by D. Haggerty1 in his commentary which questions the existence of a pediatric manpower shortage. Readers might be interested in some of our statistical data. Our group of 20 pediatricians (18 when corrected for research and administrative activities), has provided primary services to a known Kaiser Health Plan (Oregon Region) population of 55,000 children under age 17 in 1972. We have been able to function at a ratio of one pediatrician per 2,800 to 3,200 patients since 1965, when we began "keeping score."

The Education of Pediatricians for Primary Care: The Score After Two Score Years

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 270-272
Author(s):  
Evan Charney
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Medical Profession ◽  
Primary Care System ◽  
Educational Structure ◽  
Task Forces ◽  
Do So ◽  
Care System

In a 1973 monograph on the education of physicians for primary care, Joel Alpert and I wrote, "There are two interrelated and serious problems in our present educational structure—not enough physicians enter primary care and those who do so are not adequately prepared for the job."1 Twenty years and many task forces and exhortatory editorials later, much the same could be said. But that conclusion would not be entirely fair: changes have indeed occurred in the subsequent two score years. There is now clear consensus that a strong primary care system should be the linchpin of our nation's health care system, with 50 to 60% of physicians as generalists, 2,3 and the medical profession has at least professed to agree with that strategy.4

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