scholarly journals Primary Care and Mental Health: Overview of Integrated Care Models

2020 ◽  
Author(s):  
Margaret Brown ◽  
Catherine A. Moore ◽  
Jill MacGregor ◽  
Jason R. Lucey
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Integrated Care ◽  
Care Models ◽  
Integrated Care Models

Pediatric Integrated Care Models: A Systematic Review

2019 ◽  
Vol 59 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Kimberly Burkhart ◽  
Kenneth Asogwa ◽  
Nida Muzaffar ◽  
Mary Gabriel
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Outcomes ◽  
Collaborative Care ◽  
Experimental Studies ◽  
Mental Health Outcomes ◽  
Care Models ◽  
Quasi Experimental ◽  
Behavioral Health Treatment ◽  
Integrated Care Models

Psychiatric disorders are becoming more frequently diagnosed within the pediatric primary care setting. Despite increased diagnosis within primary care, only a minority of patients receive further psychiatric or specialty care. The integrated/collaborative care treatment model was designed to improve access within primary care. The purpose of this review is to identify randomized controlled trials and quasi-experimental studies that have investigated whether increased access improves treatment engagement, satisfaction, and improved mental health outcomes. Six studies met inclusion criteria. Studies reviewed indicated increased access to behavioral health treatment through use of the integrated/collaborative care model and improved mental health outcomes. Recommendations for screening and treatment are provided. Limitations of the reviewed studies include lack of generalizability to urban populations, minority youth, and youth younger than 4 years of age. Practice recommendations to address these limitations are identified.

The Treatment of Schizophrenia Spectrum and Other Psychotic Disorders in Integrated Primary Care

2017 ◽  
Author(s):  
Elizabeth Lowdermilk ◽  
Nicole Joseph ◽  
Robert E Feinstein
Keyword(s):  
Primary Care ◽  
Best Practices ◽  
Integrated Care ◽  
Psychotic Disorders ◽  
Psychiatric Care ◽  
Lessons Learned ◽  
Care Model ◽  
Schizophrenia Spectrum ◽  
Care Models ◽  
Integrated Care Models

Many patients with psychotic disorders, for systemic and personal reasons, are treated in primary care, even though there currently are no evidence-based integrated care models supporting this practice. This chapter describes the screening and salient clinical features of schizophrenia and psychotic disorders, management of emergencies, the biopsychosocial-cultural evaluation, differential diagnosis (medical and psychiatric), and medications and other treatments that can be delivered by an integrated multidisciplinary team. Psychiatric specialty services are also described, so that primary care referrals to specialty psychiatric services can be offered. Special considerations are outlined for the care and treatment of psychotic women and psychotic geriatric populations. The Denver Health Medical Center’s model of integrated care is introduced, including lessons learned during its development and implementation. An integrated care model for the treatment of psychotic disorders in primary care is proposed that unites best practices of specialty psychiatric care with the fundamentals of integrated care.

scholarly journals Evaluating integrated care for people with complex needs

2020 ◽  
Vol 26 (1) ◽  
pp. 46-53
Author(s):  
Panagiotis Kasteridis ◽  
Anne Mason ◽  
Andrew Street
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Models Of Care ◽  
Care Team ◽  
Future Research ◽  
Complex Care ◽  
Care Needs ◽  
Complex Needs ◽  
Care Models ◽  
Integrated Care Models

Objectives As part of the Vanguard programme, two integrated care models were introduced in South Somerset for people with complex care needs: the Complex Care Team and Enhanced Primary Care. We assessed their impact on a range of utilization measures and mortality. Methods We used monthly individual-level linked primary and secondary care data from April 2014 to March 2018 to assess outcomes before and after the introduction of the care models. The analysis sample included 564 Complex Care Team and 841 Enhanced Primary Care cases that met specific criteria. We employed propensity score methods to identify out-of-area control patients and difference-in-differences analysis to isolate the care models’ impact. Results We found no evidence of significantly reduced utilization in any of the Complex Care Team or Enhanced Primary Care cohorts. The death rate was significantly lower only for those in the first Enhanced Primary Care cohort. Conclusions The integrated care models did not significantly reduce utilization nor consistently reduce mortality. Future research should test longer-term outcomes associated with the new models of care and quantify their contribution in the context of broader initiatives.

scholarly journals Impact of Relaxation and Group Psycho-Education on Health Outcomes Using Integrated Care Models and Quality Improvement

2014 ◽  
Vol 04 (12) ◽  
pp. 887-896 ◽  
Author(s):  
Martha Okafor ◽  
Victor Ede ◽  
Rosemary Kinuthia ◽  
Debbie Strotz ◽  
Cathryn Marchman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Outcomes ◽  
Integrated Care ◽  
Care Models ◽  
Integrated Care Models

Integrating Clinical Nurse Specialists into the Treatment of Primary Care Patients with Depression

2003 ◽  
Vol 33 (1) ◽  
pp. 17-37 ◽  
Author(s):  
Ralph W. Swindle ◽  
Jaya K. Rao ◽  
Ahdy Helmy ◽  
Laurie Plue ◽  
X. H. Zhou ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Integrated Care ◽  
Medical Center ◽  
Treatment Plan ◽  
Intervention Group ◽  
Nurse Specialist ◽  
Clinical Nurse ◽  
Primary Care Patients

Objective: To examine the effectiveness of integrating generalist and specialist care for veterans with depression. Method: We conducted a randomized trial of patients screening positive for depression at two Veterans Affairs Medical Center general medicine clinic firms. Control firm physicians were notified prior to the encounter when eligible patients had PRIME-MD depression diagnoses. In the intervention firm, a mental health clinical nurse specialist (CNS) was to: design a treatment plan; implement that plan with the primary care physician; and monitor patients via telephone or visits at two weeks, one month and two months. Primary outcomes (depressive symptoms, patient satisfaction with health care) were collected at 3 and 12 months. Results: Of 268 randomized patients, 246 (92%) and 222 (83%) completed 3- and 12-month follow-up interviews. There were no between-group differences in depressive symptoms or satisfaction at 3 or 12 months. The intervention group had greater chart documentation of depression at baseline (63% versus 33%, p = 0.003) and a higher referral rate to mental health services at 3 months (27% versus 9%, p = 0.019). There was no difference in the rate of new prescriptions for, or adequate dosing of, anti-depressant medications. In 40% of patients, CNSs disagreed with the PRIME-MD depression diagnosis, and their rates of watchful waiting were correspondingly high. Conclusions: Implementing an integrated care model did not occur as intended. Experienced CNSs often did not see the need for treatment in many primary care patients identified by the PRIME-MD. Integrating integrated care models in actual practice may prove challenging.

Effectiveness and cost-effectiveness of integrated care models for elderly, complex patients: A narrative review. Don’t we need a value-based approach?

2018 ◽  
Vol 21 (4) ◽  
pp. 120-139 ◽  
Author(s):  
Marta Marino ◽  
Antonio G de Belvis ◽  
Maria Tanzariello ◽  
Emanuele Dotti ◽  
Sabina Bucci ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Outcomes ◽  
Integrated Care ◽  
Service Providers ◽  
Systems Of Care ◽  
Social Needs ◽  
Narrative Review ◽  
A Value ◽  
Care Models ◽  
Integrated Care Models

Introduction The management of patients with complex health and social needs is one of the main challenges for healthcare systems. Integrated care seems to respond to this issue, with collaborative working and integration efforts of the care system components professionals and service providers aimed at improving efficiency, appropriateness and person centeredness of care. We conducted a narrative review to analyse the available evidences published on effectiveness and cost-effectiveness of integrated care models targeted on the management of such elderly patients. Methods MEDLINE, Scopus and EBSCO were searched. We reported this narrative review according to the PRISMA Checklist. For studies to be included, they had to: (i) refer to integrated care models through implemented experimental or demonstration projects; (ii) focus on frail elderly ≥65 years old, with complex health and social needs, not disease-specific; (iii) evaluate effectiveness and/or cost and/or cost-effectiveness; (iv) report quantitative data (e.g. health outcomes, utilization outcomes, cost and cost-effectiveness). Results Thirty articles were included, identifying 13 integrated care models. Common features were identified in case management, geriatric assessment and multidisciplinary team. Favourable impacts on healthcare facilities utilization rates, though with mixed results on costs, were found. The development of community-based and cost-effective integrated systems of care for the elderly is possible, thanks to the cooperation across care professionals and providers, to achieving a relevant impact on healthcare and efficient resource management. The elements of success or failure are not always unique and identifiable, but the potential clearly exists for these models to be successful and generalized on a large scale. Discussion We found out a favourable impact of integrated care models/methods on health outcomes, care utilization and costs. The selected interventions are likely to be implemented at community level, focused on the patient management in terms of continuity of care. Thus, we propose a value-based framework for the evaluation of these services.

scholarly journals Integrated Care Models and Child Health: A Meta-analysis

PEDIATRICS ◽  
2019 ◽  
Vol 145 (1) ◽  
pp. e20183747 ◽  
Author(s):  
Ingrid Wolfe ◽  
Rose-Marie Satherley ◽  
Elizabeth Scotney ◽  
James Newham ◽  
Raghu Lingam
Keyword(s):  
Child Health ◽  
Integrated Care ◽  
Meta Analysis ◽  
Care Models ◽  
Integrated Care Models ◽  
And Child Health
Sign in / Sign up

Export Citation Format

Share Document