Mental health care integration and primary care patient experience in the Veterans Health Administration
| Autor: | Catherine E. Brayton, Lisa V. Rubenstein, Lucinda B. Leung, Danielle E. Rose, Rong Guo, Susan Stockdale |
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| Rok vydání: | 2021 |
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Research design
Receipt medicine.medical_specialty Primary Health Care business.industry Health Policy Veterans Health Mental health Care provision United States Odds Patient Outcome Assessment United States Department of Veterans Affairs Patient satisfaction Cross-Sectional Studies Mental Health Family medicine Patient experience Medicine Humans business Administration (government) |
| Zdroj: | Healthcare (Amsterdam, Netherlands). 9(4) |
| ISSN: | 2213-0772 |
| Popis: | Background Mental health specialists and care managers facilitate comprehensive care provision within medical homes. Despite implementation challenges, mental health integration is thought to improve patient-centered primary care. Objectives To examine the relationship between primary care patient experience and mental health integration. Research design Cross-sectional surveys from 168 primary care clinicians (PCPs) (n = 226) matched with assigned patients’ surveys (n = 1734) in one Veterans Health Administration (VA) region, fiscal years 2012–2013. Multilevel regression models examined patient experience and mental health integration, adjusting for patient and PCP characteristics. Measures Patient experience outcomes were (1) experience with PCP and (2) receipt of comprehensive care, such as talked about “stress”. Independent variables represented mental health integration— (1) PCP-rated communication with mental health and (2) proportion of clinic patients who saw integrated specialists. Results 50% and 43% of patients rated their PCPs 10/10 and reported receiving comprehensive care, respectively. Neither patient experience or receipt of comprehensive care was significantly associated with PCP's ratings of communication with mental health, nor with proportion of clinic patients who saw integrated specialists. Among a subsample of patients who rated their mental health as poor/fair, however, we detected an association between proportion of clinic patients who saw integrated specialists and patient experience (odds ratio = 1.05, 95% confidence interval = 1.01–1.09, p = .01). Conclusions No association was observed between mental health integration and primary care patients’ reported care experiences, but a significant association existed among patients who reported poor/fair mental health. More research is needed to understand patient experiences with regard to care model implementation. |
| Databáze: | OpenAIRE |
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