TY - JOUR
T1 - Outcomes of integrated behavioral health with primary care
AU - Balasubramanian, Bijal A.
AU - Cohen, Deborah J.
AU - Jetelina, Katelyn K.
AU - Dickinson, L. Miriam
AU - Davis, Melinda
AU - Gunn, Rose
AU - Gowen, Kris
AU - DeGruy, Frank V.
AU - Miller, Benjamin F.
AU - Green, Larry A.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background: Integrating behavioral health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients' experience of care. Methods: This study used a convergent mixed-methods design, merging findings from a quasi-experimental study with patient interviews conducted as part of Advancing Care Together, a community demonstration project that created an innovation incubator for practices implementing evidence-based integration strategies. The study included 475 patients with a 9-item Patient Health Questionnaire (PHQ-9) score ≥10 at baseline, from 5 practices. Results: Statistically significant reductions in mean PHQ-9 scores were observed in all practices, ranging from 2.72 to 6.46 points. Clinically, 50% of patients had a ≥5-point reduction in PHQ-9 score and 32% had a ≥50% reduction. This finding was corroborated by patient interviews that demonstrated positive experiences with behavioral health clinicians and acquiring new skills to cope with adverse situations at work and home. Conclusions: Integrating behavioral health and primary care, when adapted to fit into community practices, reduced depression severity and enhanced patients' experience of care. Integration is a worthwhile investment; clinical leaders, policymakers, and payers should support integration in their communities.
AB - Background: Integrating behavioral health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients' experience of care. Methods: This study used a convergent mixed-methods design, merging findings from a quasi-experimental study with patient interviews conducted as part of Advancing Care Together, a community demonstration project that created an innovation incubator for practices implementing evidence-based integration strategies. The study included 475 patients with a 9-item Patient Health Questionnaire (PHQ-9) score ≥10 at baseline, from 5 practices. Results: Statistically significant reductions in mean PHQ-9 scores were observed in all practices, ranging from 2.72 to 6.46 points. Clinically, 50% of patients had a ≥5-point reduction in PHQ-9 score and 32% had a ≥50% reduction. This finding was corroborated by patient interviews that demonstrated positive experiences with behavioral health clinicians and acquiring new skills to cope with adverse situations at work and home. Conclusions: Integrating behavioral health and primary care, when adapted to fit into community practices, reduced depression severity and enhanced patients' experience of care. Integration is a worthwhile investment; clinical leaders, policymakers, and payers should support integration in their communities.
KW - Behavioral Medicine
KW - Community Health Services
KW - Depression
KW - Integrated Health Care Systems
KW - Primary Health Care
KW - Surveys and Questionnaires
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U2 - 10.3122/jabfm.2017.02.160234
DO - 10.3122/jabfm.2017.02.160234
M3 - Article
C2 - 28379819
AN - SCOPUS:85016633422
SN - 1557-2625
VL - 30
SP - 130
EP - 139
JO - Journal of the American Board of Family Medicine
JF - Journal of the American Board of Family Medicine
IS - 2
ER -