Characteristics and behavioral health needs of patients with patterns of high hospital use: implications for primary care providers
| Autor: | Laura Buckley, Karen G. Rentas, Dawn Wiest, Cortney Bruno |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Mental Health Services medicine.medical_specialty Adolescent Substance-Related Disorders Health Personnel Vulnerable populations Medical Overuse Substance use Health informatics Health administration Young Adult Complex care 03 medical and health sciences 0302 clinical medicine Care coordination Health care Humans Medicine 030212 general & internal medicine Primary health care Health Services Needs and Demand Medical Audit New Jersey business.industry Mental Disorders lcsh:Public aspects of medicine 030503 health policy & services Health Policy Nursing research Public health Integrated care lcsh:RA1-1270 Behavioral health medicine.disease Mental health Hospitals Substance abuse Family medicine Female Self Report 0305 other medical science business Research Article |
| Zdroj: | BMC Health Services Research, Vol 19, Iss 1, Pp 1-8 (2019) BMC Health Services Research |
| ISSN: | 1472-6963 |
| Popis: | Background A small percentage of patients relies extensively on hospital-based care and account for a disproportionately high share of health care spending in the United States. Evidence shows that behavioral health conditions are common among these individuals, but understanding of their behavioral health needs is limited. This study aimed to understand the behavioral health characteristics and needs of patients with high hospital utilization patterns in Camden, New Jersey. Methods The sample consisted of patients in a care management intervention for individuals with patterns of high hospital utilization who were referred for behavioral health assessments (N = 195). A clinical psychologist conducted the assessments, which informed a multiaxial evaluation with diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders and a Mental Status Examination, to facilitate accurate diagnosis. Demographic characteristics, housing instability, exposure to trauma, and health care service utilization data were also collected through self-report and chart reviews. Results Ninety percent of patients were diagnosed with a psychiatric and/or active substance use disorder. Depression was the most common psychiatric disorder and alcohol use was the most common substance use disorder. However, only 10% of patients with an active substance use disorder were in treatment, and only 17% of patients with a mental health diagnosis were receiving mental health treatment. Nearly all (91%) patients reported having a primary care provider at the time of assessment and most had seen their primary care provider within three months of their last hospital discharge. Non-medical barriers to health and wellness, specifically housing instability and exposure to trauma, were also common (35 and 61% of patients, respectively) among patients. Conclusion Findings highlight the importance of identifying and treating patients with behavioral health needs in the primary care setting. Developing connections with community agencies who provide behavioral health and substance use treatment can enhance primary care providers’ efforts to address their patients’ non-medical barriers to treatment, as can embedding behavioral health providers within primary care offices. The study also underscores the need for trauma-informed care in primary care settings. |
| Databáze: | OpenAIRE |
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