A Successful Walk-In Psychiatric Model for Integrated Care
| Autor: | Laura S. Shea, Meagan Siciliano, David Gitlin, Lisa Irwin, Carol Latham, David S. Kroll, Janice Mahal, Bonnie Southworth |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Outpatient Clinics Hospital Primary care Vulnerable Populations Health Services Accessibility Session (web analytics) Appointments and Schedules 03 medical and health sciences Underserved Population 0302 clinical medicine Humans Medicine 030212 general & internal medicine Medical diagnosis Psychiatry Primary Health Care Delivery of Health Care Integrated Medicaid business.industry Walk-in Mental Disorders Public Health Environmental and Occupational Health Hispanic or Latino Middle Aged United States 030227 psychiatry Integrated care Black or African American Models Organizational Behavioral medicine Female Family Practice business |
| Zdroj: | The Journal of the American Board of Family Medicine. 32:481-489 |
| ISSN: | 1558-7118 1557-2625 |
| DOI: | 10.3122/jabfm.2019.04.180357 |
| Popis: | Purpose: Accommodating walk-in psychiatry visits in primary care can improve access to psychiatric care for patients from historically underserved groups. We sought to determine whether a walk-in psychiatry model embedded within an integrated care practice could be sustained over time, and to characterize the patients who accessed care through it. Methods: We reviewed electronic health records linked to 811 psychiatry encounters in an integrated care practice between October 1, 2015 and September 30, 2017. Primary outcomes were the initial and return psychiatry encounters per month. Secondary outcomes were the demographics and diagnoses of patients who accessed their initial visits through walk-in sessions and scheduled appointments. Results: 490 initial psychiatry evaluations and 321 return encounters took place over the 2-year study period. The volume of initial psychiatry evaluations per month did not significantly change, but the volume of psychiatry follow-up encounters significantly increased after the walk-in session expanded. Medicaid recipients (OR, 1.9; 95% CI, 1.2 to 3.0); individuals without a college degree (OR, 1.7; 95% CI, 1.1 to 2.5); individuals who were single, divorced, or separated (OR, 1.7; 95% CI, 1.1 to 2.5); and individuals who identified as Black or Hispanic (OR, 2.5; 95% CI, 1.7 to 3.6) were more likely to access an initial psychiatry evaluation through a walk-in session as opposed to a scheduled appointment. Conclusions: Providing psychiatric care on a walk-in basis in integrated care is sustainable. Patients from historically underserved groups may access psychiatric care disproportionately through a walk-in option when it is available. |
| Databáze: | OpenAIRE |
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