Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.

Autor: Grove LR; Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr., Chapel Hill, NC 27599-7411, United States. Electronic address: lrgrove@live.unc.edu., Olesiuk WJ; Truven Health Analytics, an IBM Company, 4819 Emperor Blvd Ste 125, Durham, NC 27703, United States; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599-7590, United States. Electronic address: wolesiuk@gmail.com., Ellis AR; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599-7590, United States; Department of Social Work, North Carolina State University, CB 7639, 1911 Building, Raleigh, NC 27695-7639, United States. Electronic address: arellis@ncsu.edu., Lichstein JC; Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr., Chapel Hill, NC 27599-7411, United States. Electronic address: jlichstein@hrsa.gov., DuBard CA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599-7590, United States; Community Care of North Carolina, 2300 Rexwoods Dr., Ste 200, Raleigh, NC 27607, United States. Electronic address: annettedubard@gmail.com., Farley JF; Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Kerr Hall, Chapel Hill, NC 27599-7573, United States. Electronic address: jffarley@unc.edu., Jackson CT; Community Care of North Carolina, 2300 Rexwoods Dr., Ste 200, Raleigh, NC 27607, United States. Electronic address: cjackson@n3cn.org., Beadles CA; RTI International, 3040 E Cornwallis Rd, Durham, NC 27709, United States. Electronic address: cbeadles@rti.org., Morrissey JP; Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr., Chapel Hill, NC 27599-7411, United States; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599-7590, United States. Electronic address: jmorriss@schsr.unc.edu., Domino ME; Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr., Chapel Hill, NC 27599-7411, United States; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, Chapel Hill, NC 27599-7590, United States. Electronic address: domino@unc.edu.
Jazyk: angličtina
Zdroj: General hospital psychiatry [Gen Hosp Psychiatry] 2017 Jul; Vol. 47, pp. 14-19. Date of Electronic Publication: 2017 Mar 07.
DOI: 10.1016/j.genhosppsych.2017.03.002
Abstrakt: Objective: Primary care-based medical homes could improve the coordination of mental health care for individuals with schizophrenia and comorbid chronic conditions. The objective of this paper is to examine whether persons with schizophrenia and comorbid chronic conditions engage in primary care regularly, such that primary care settings have the potential to serve as a mental health home.
Method: We examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007-2010. Using a fixed-effects regression approach, we also assessed the effect of medical home enrollment on utilization of primary care and specialty mental health care and medication adherence.
Results: A substantial majority (78.5%) of person-years had at least one primary care visit, and 17.9% had at least one primary care visit but no specialty mental health services use. Medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence.
Conclusions: Medical home enrollees with schizophrenia and comorbid chronic conditions exhibited significant engagement in primary care, suggesting that primary-care-based medical homes could serve a care coordination function for persons with schizophrenia.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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