Integrating Primary Care Into Community Mental Health Centers: Impact on Utilization and Costs of Health Care
Objective:This evaluation was designed to assess the impact of providing integrated primary and mental health care on utilization and costs for outpatient medical, inpatient hospital, and emergency department treatment among persons with serious mental illness.Methods:Two safety-net, community menta...
Gespeichert in:
| Veröffentlicht in: | Psychiatric Services 2016-11, Vol.67 (11), p.1233-1239 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1239 |
|---|---|
| container_issue | 11 |
| container_start_page | 1233 |
| container_title | Psychiatric Services |
| container_volume | 67 |
| creator | Krupski, Antoinette West, Imara I Scharf, Deborah M Hopfenbeck, James Andrus, Graydon Joesch, Jutta M Snowden, Mark |
| description | Objective:This evaluation was designed to assess the impact of providing integrated primary and mental health care on utilization and costs for outpatient medical, inpatient hospital, and emergency department treatment among persons with serious mental illness.Methods:Two safety-net, community mental health centers that received a Substance Abuse and Mental Health Services Administration Primary and Behavioral Health Care Integration (PBHCI) grant were the focus of this study. Clinic 1 had a ten-year history of providing integrated services whereas clinic 2 began integrated services with the PBHCI grant. Difference-in-differences (DID) analyses were used to compare individuals enrolled in the PBHCI programs (N=373, clinic 1; N=389, clinic 2) with propensity score–matched comparison groups of equal size at each site by using data obtained from medical records.Results:Relative to the comparison groups, a higher proportion of PBHCI clients used outpatient medical services at both sites following program enrollment (p |
| doi_str_mv | 10.1176/appi.ps.201500424 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826709758</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826709758</sourcerecordid><originalsourceid>FETCH-LOGICAL-a411t-9fa6452b53804f8ddc61adcf47806b8fec8fd442e96f33844ffba817e89482203</originalsourceid><addsrcrecordid>eNp1kU9PwyAYxonRuDn9AF4MiRcvrUChUG-mUbdkRg_u3NAWZpf-E-hhfnqZnTMx8cQL_J7nffM-AFxiFGLM41vZ91XY25AgzBCihB6BKWaMBwlH6NjXiLOA8AhNwJm1G4QQ5jg-BRP_FlOB2RQ0i9aptZGuatfw1VSNNFuYSqOg_-hg2jXN0FZuC59V62QN50rW7h2m_qaMvYOLppeFg10LV66qq09v5GvZll5qnYWdPki86Tk40bK26mJ_zsDq8eEtnQfLl6dFer8MJMXYBYmWMWUkZ5FAVIuyLGIsy0JTLlCcC60KoUtKiUpiHUWCUq1zKTBXIqGCEBTNwM3o25vuY1DWZU1lC1XXslXdYDMsSMxRwpnw6PUfdNMNpvXTeSpKKMV-CE_hkSpMZ61ROuvHXWUYZbsssl0WWW-zQxZec7V3HvJGlQfFz_I9EI7At_a37b-OX6fWlJk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1839441380</pqid></control><display><type>article</type><title>Integrating Primary Care Into Community Mental Health Centers: Impact on Utilization and Costs of Health Care</title><source>MEDLINE</source><source>American Psychiatric Publishing</source><source>EZB Electronic Journals Library</source><creator>Krupski, Antoinette ; West, Imara I ; Scharf, Deborah M ; Hopfenbeck, James ; Andrus, Graydon ; Joesch, Jutta M ; Snowden, Mark</creator><creatorcontrib>Krupski, Antoinette ; West, Imara I ; Scharf, Deborah M ; Hopfenbeck, James ; Andrus, Graydon ; Joesch, Jutta M ; Snowden, Mark</creatorcontrib><description>Objective:This evaluation was designed to assess the impact of providing integrated primary and mental health care on utilization and costs for outpatient medical, inpatient hospital, and emergency department treatment among persons with serious mental illness.Methods:Two safety-net, community mental health centers that received a Substance Abuse and Mental Health Services Administration Primary and Behavioral Health Care Integration (PBHCI) grant were the focus of this study. Clinic 1 had a ten-year history of providing integrated services whereas clinic 2 began integrated services with the PBHCI grant. Difference-in-differences (DID) analyses were used to compare individuals enrolled in the PBHCI programs (N=373, clinic 1; N=389, clinic 2) with propensity score–matched comparison groups of equal size at each site by using data obtained from medical records.Results:Relative to the comparison groups, a higher proportion of PBHCI clients used outpatient medical services at both sites following program enrollment (p<.003, clinic 1; p<.001, clinic 2). At clinic 1, PBHCI was also associated with a reduction in the proportion of clients with an inpatient hospital admission (p=.04) and a trend for a reduction in inpatient hospital costs per member per month of $217.68 (p=.06). Hospital-related cost savings were not observed for PBHCI clients at clinic 2 nor were there significant differences between emergency department use or costs for PBHCI and comparison groups at either clinic.Conclusions:Investments in PBHCI can improve access to outpatient medical care for persons with severe mental illness and may also curb hospitalizations and associated costs in more established programs.</description><identifier>ISSN: 1075-2730</identifier><identifier>EISSN: 1557-9700</identifier><identifier>DOI: 10.1176/appi.ps.201500424</identifier><identifier>PMID: 27364815</identifier><language>eng</language><publisher>United States: American Psychiatric Association</publisher><subject>Adult ; Ambulatory Care - economics ; Ambulatory Care - statistics & numerical data ; Ambulatory Care - utilization ; Community Mental Health Services - economics ; Community Mental Health Services - statistics & numerical data ; Community Mental Health Services - utilization ; Delivery of Health Care, Integrated - economics ; Delivery of Health Care, Integrated - statistics & numerical data ; Delivery of Health Care, Integrated - utilization ; Female ; Health care expenditures ; Health services utilization ; Hospitalization ; Humans ; Impact analysis ; Male ; Mental disorders ; Mental Disorders - therapy ; Middle Aged ; Primary Health Care - economics ; Primary Health Care - statistics & numerical data ; Primary Health Care - utilization</subject><ispartof>Psychiatric Services, 2016-11, Vol.67 (11), p.1233-1239</ispartof><rights>Copyright © 2016 by the American Psychiatric Association</rights><rights>Copyright American Psychiatric Publishing, Inc. Nov 1, 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a411t-9fa6452b53804f8ddc61adcf47806b8fec8fd442e96f33844ffba817e89482203</citedby><cites>FETCH-LOGICAL-a411t-9fa6452b53804f8ddc61adcf47806b8fec8fd442e96f33844ffba817e89482203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/appi.ps.201500424$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/appi.ps.201500424$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,776,780,2842,21605,21606,21607,27901,27902,77536,77541</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27364815$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krupski, Antoinette</creatorcontrib><creatorcontrib>West, Imara I</creatorcontrib><creatorcontrib>Scharf, Deborah M</creatorcontrib><creatorcontrib>Hopfenbeck, James</creatorcontrib><creatorcontrib>Andrus, Graydon</creatorcontrib><creatorcontrib>Joesch, Jutta M</creatorcontrib><creatorcontrib>Snowden, Mark</creatorcontrib><title>Integrating Primary Care Into Community Mental Health Centers: Impact on Utilization and Costs of Health Care</title><title>Psychiatric Services</title><addtitle>Psychiatr Serv</addtitle><description>Objective:This evaluation was designed to assess the impact of providing integrated primary and mental health care on utilization and costs for outpatient medical, inpatient hospital, and emergency department treatment among persons with serious mental illness.Methods:Two safety-net, community mental health centers that received a Substance Abuse and Mental Health Services Administration Primary and Behavioral Health Care Integration (PBHCI) grant were the focus of this study. Clinic 1 had a ten-year history of providing integrated services whereas clinic 2 began integrated services with the PBHCI grant. Difference-in-differences (DID) analyses were used to compare individuals enrolled in the PBHCI programs (N=373, clinic 1; N=389, clinic 2) with propensity score–matched comparison groups of equal size at each site by using data obtained from medical records.Results:Relative to the comparison groups, a higher proportion of PBHCI clients used outpatient medical services at both sites following program enrollment (p<.003, clinic 1; p<.001, clinic 2). At clinic 1, PBHCI was also associated with a reduction in the proportion of clients with an inpatient hospital admission (p=.04) and a trend for a reduction in inpatient hospital costs per member per month of $217.68 (p=.06). Hospital-related cost savings were not observed for PBHCI clients at clinic 2 nor were there significant differences between emergency department use or costs for PBHCI and comparison groups at either clinic.Conclusions:Investments in PBHCI can improve access to outpatient medical care for persons with severe mental illness and may also curb hospitalizations and associated costs in more established programs.</description><subject>Adult</subject><subject>Ambulatory Care - economics</subject><subject>Ambulatory Care - statistics & numerical data</subject><subject>Ambulatory Care - utilization</subject><subject>Community Mental Health Services - economics</subject><subject>Community Mental Health Services - statistics & numerical data</subject><subject>Community Mental Health Services - utilization</subject><subject>Delivery of Health Care, Integrated - economics</subject><subject>Delivery of Health Care, Integrated - statistics & numerical data</subject><subject>Delivery of Health Care, Integrated - utilization</subject><subject>Female</subject><subject>Health care expenditures</subject><subject>Health services utilization</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Impact analysis</subject><subject>Male</subject><subject>Mental disorders</subject><subject>Mental Disorders - therapy</subject><subject>Middle Aged</subject><subject>Primary Health Care - economics</subject><subject>Primary Health Care - statistics & numerical data</subject><subject>Primary Health Care - utilization</subject><issn>1075-2730</issn><issn>1557-9700</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9PwyAYxonRuDn9AF4MiRcvrUChUG-mUbdkRg_u3NAWZpf-E-hhfnqZnTMx8cQL_J7nffM-AFxiFGLM41vZ91XY25AgzBCihB6BKWaMBwlH6NjXiLOA8AhNwJm1G4QQ5jg-BRP_FlOB2RQ0i9aptZGuatfw1VSNNFuYSqOg_-hg2jXN0FZuC59V62QN50rW7h2m_qaMvYOLppeFg10LV66qq09v5GvZll5qnYWdPki86Tk40bK26mJ_zsDq8eEtnQfLl6dFer8MJMXYBYmWMWUkZ5FAVIuyLGIsy0JTLlCcC60KoUtKiUpiHUWCUq1zKTBXIqGCEBTNwM3o25vuY1DWZU1lC1XXslXdYDMsSMxRwpnw6PUfdNMNpvXTeSpKKMV-CE_hkSpMZ61ROuvHXWUYZbsssl0WWW-zQxZec7V3HvJGlQfFz_I9EI7At_a37b-OX6fWlJk</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Krupski, Antoinette</creator><creator>West, Imara I</creator><creator>Scharf, Deborah M</creator><creator>Hopfenbeck, James</creator><creator>Andrus, Graydon</creator><creator>Joesch, Jutta M</creator><creator>Snowden, Mark</creator><general>American Psychiatric Association</general><general>American Psychiatric Publishing, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20161101</creationdate><title>Integrating Primary Care Into Community Mental Health Centers: Impact on Utilization and Costs of Health Care</title><author>Krupski, Antoinette ; West, Imara I ; Scharf, Deborah M ; Hopfenbeck, James ; Andrus, Graydon ; Joesch, Jutta M ; Snowden, Mark</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a411t-9fa6452b53804f8ddc61adcf47806b8fec8fd442e96f33844ffba817e89482203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Ambulatory Care - economics</topic><topic>Ambulatory Care - statistics & numerical data</topic><topic>Ambulatory Care - utilization</topic><topic>Community Mental Health Services - economics</topic><topic>Community Mental Health Services - statistics & numerical data</topic><topic>Community Mental Health Services - utilization</topic><topic>Delivery of Health Care, Integrated - economics</topic><topic>Delivery of Health Care, Integrated - statistics & numerical data</topic><topic>Delivery of Health Care, Integrated - utilization</topic><topic>Female</topic><topic>Health care expenditures</topic><topic>Health services utilization</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Impact analysis</topic><topic>Male</topic><topic>Mental disorders</topic><topic>Mental Disorders - therapy</topic><topic>Middle Aged</topic><topic>Primary Health Care - economics</topic><topic>Primary Health Care - statistics & numerical data</topic><topic>Primary Health Care - utilization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krupski, Antoinette</creatorcontrib><creatorcontrib>West, Imara I</creatorcontrib><creatorcontrib>Scharf, Deborah M</creatorcontrib><creatorcontrib>Hopfenbeck, James</creatorcontrib><creatorcontrib>Andrus, Graydon</creatorcontrib><creatorcontrib>Joesch, Jutta M</creatorcontrib><creatorcontrib>Snowden, Mark</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Psychiatric Services</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krupski, Antoinette</au><au>West, Imara I</au><au>Scharf, Deborah M</au><au>Hopfenbeck, James</au><au>Andrus, Graydon</au><au>Joesch, Jutta M</au><au>Snowden, Mark</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Integrating Primary Care Into Community Mental Health Centers: Impact on Utilization and Costs of Health Care</atitle><jtitle>Psychiatric Services</jtitle><addtitle>Psychiatr Serv</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>67</volume><issue>11</issue><spage>1233</spage><epage>1239</epage><pages>1233-1239</pages><issn>1075-2730</issn><eissn>1557-9700</eissn><abstract>Objective:This evaluation was designed to assess the impact of providing integrated primary and mental health care on utilization and costs for outpatient medical, inpatient hospital, and emergency department treatment among persons with serious mental illness.Methods:Two safety-net, community mental health centers that received a Substance Abuse and Mental Health Services Administration Primary and Behavioral Health Care Integration (PBHCI) grant were the focus of this study. Clinic 1 had a ten-year history of providing integrated services whereas clinic 2 began integrated services with the PBHCI grant. Difference-in-differences (DID) analyses were used to compare individuals enrolled in the PBHCI programs (N=373, clinic 1; N=389, clinic 2) with propensity score–matched comparison groups of equal size at each site by using data obtained from medical records.Results:Relative to the comparison groups, a higher proportion of PBHCI clients used outpatient medical services at both sites following program enrollment (p<.003, clinic 1; p<.001, clinic 2). At clinic 1, PBHCI was also associated with a reduction in the proportion of clients with an inpatient hospital admission (p=.04) and a trend for a reduction in inpatient hospital costs per member per month of $217.68 (p=.06). Hospital-related cost savings were not observed for PBHCI clients at clinic 2 nor were there significant differences between emergency department use or costs for PBHCI and comparison groups at either clinic.Conclusions:Investments in PBHCI can improve access to outpatient medical care for persons with severe mental illness and may also curb hospitalizations and associated costs in more established programs.</abstract><cop>United States</cop><pub>American Psychiatric Association</pub><pmid>27364815</pmid><doi>10.1176/appi.ps.201500424</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1075-2730 |
| ispartof | Psychiatric Services, 2016-11, Vol.67 (11), p.1233-1239 |
| issn | 1075-2730 1557-9700 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1826709758 |
| source | MEDLINE; American Psychiatric Publishing; EZB Electronic Journals Library |
| subjects | Adult Ambulatory Care - economics Ambulatory Care - statistics & numerical data Ambulatory Care - utilization Community Mental Health Services - economics Community Mental Health Services - statistics & numerical data Community Mental Health Services - utilization Delivery of Health Care, Integrated - economics Delivery of Health Care, Integrated - statistics & numerical data Delivery of Health Care, Integrated - utilization Female Health care expenditures Health services utilization Hospitalization Humans Impact analysis Male Mental disorders Mental Disorders - therapy Middle Aged Primary Health Care - economics Primary Health Care - statistics & numerical data Primary Health Care - utilization |
| title | Integrating Primary Care Into Community Mental Health Centers: Impact on Utilization and Costs of Health Care |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T17%3A21%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Integrating%20Primary%20Care%20Into%20Community%20Mental%20Health%20Centers:%20Impact%20on%20Utilization%20and%20Costs%20of%20Health%20Care&rft.jtitle=Psychiatric%20Services&rft.au=Krupski,%20Antoinette&rft.date=2016-11-01&rft.volume=67&rft.issue=11&rft.spage=1233&rft.epage=1239&rft.pages=1233-1239&rft.issn=1075-2730&rft.eissn=1557-9700&rft_id=info:doi/10.1176/appi.ps.201500424&rft_dat=%3Cproquest_cross%3E1826709758%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1839441380&rft_id=info:pmid/27364815&rfr_iscdi=true |