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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- (-) Behavioral Health (13)
- Care Management (1)
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- Decision Making (1)
- Depression (2)
- Diagnostic Safety and Quality (1)
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- Primary Care (12)
- (-) Primary Care: Models of Care (13)
- Racial and Ethnic Minorities (1)
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- Screening (3)
- Substance Abuse (1)
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- Training (1)
- Web-Based (1)
- Young Adults (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedGrove LR, Gertner AK, Swietek KE
Effect of enhanced primary care for people with serious mental illness on service use and screening.
This retrospective cohort study compared healthcare use and screening receipt of people with serious mental illness (SMI) newly receiving enhanced primary care to people with SMI newly receiving usual primary care. Outcome measures included outpatient visits, emergency department (ED) visits, inpatient stays and dates, and recommended screenings 18 months after the initial visit. Enhanced primary care was associated with an increase of 1.2 primary care visits in the 18 months after the initial visit and decreases of 0.33 non-psychiatric inpatient days and 3.0 non-psychiatric inpatient days. There was no significant effect on psychiatric service and ED visits. Enhanced primary care increased the probability of preventive screenings such as glucose and HIV, decreased the probability of lipid screening, and had no effect on hemoglobin A1c and colorectal cancer screening.
AHRQ-funded; HS000032.
Citation: Grove LR, Gertner AK, Swietek KE .
Effect of enhanced primary care for people with serious mental illness on service use and screening.
J Gen Intern Med 2021 Apr;36(4):970-77. doi: 10.1007/s11606-020-06429-2..
Keywords: Behavioral Health, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Screening, Healthcare Utilization, Healthcare Delivery
Yeung K, Richards J, Goemer E
Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system.
The purpose of this study was to describe the cost of using evidence-based implementation strategies for sustained behavioral health integration (BHI) involving population-based screening, assessment, and identification at 25 primary care sites of Kaiser Permanente Washington (2015-2018). The investigators concluded that when spread across patients screened in a single year, BHI implementation costs were well within the range for commonly used diagnostic assessments in primary care (eg, laboratory tests).
AHRQ-funded; HS023173.
Citation: Yeung K, Richards J, Goemer E .
Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system.
Health Serv Res 2020 Dec;55(6):913-23. doi: 10.1111/1475-6773.13592..
Keywords: Healthcare Costs, Evidence-Based Practice, Implementation, Behavioral Health, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare
McClellan C, Maclean JC, Saloner B
AHRQ Author: McClellan C
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
This study provided the first population-level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use. As of 2016, 16 states had adopted an HH for enrollees with serious mental illness and/or substance use disorder. Using data from the National Survey on Drug Use and Health, the authors found that HH adoption increased service use among enrollees and enrollee self-reported health improved post-HH.
AHRQ-authored.
Citation: McClellan C, Maclean JC, Saloner B .
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
Health Econ 2020 Sep;29(9):1086-97. doi: 10.1002/hec.4027..
Keywords: Behavioral Health, Medicaid, Substance Abuse, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Patient-Centered Outcomes Research
Golberstein E, Joseph JM, Druss BG
The use of psychiatric econsults in primary care.
This study examined the use of an electronic consultation tool (eConsult) by primary care physicians (PCPs) with psychiatrists. The authors investigated the use of psychiatric eConsults in a large integrated delivery system in Minnesota (Allina Health). The tool was introduced in 22 of its primary care clinics on August 1, 2015. Patients had no fee and psychiatrists received 0.75 work relative value units for each eConsult. Out of 95,105 encounters across 219 PCPs from August 2015 through December 2016 only 256 (0.27%) had a psychiatric eConsult order. Among 37.606 encounters with a primary mental health diagnosis only 138 (0.37%) had an eConsult order. Anxiety and depressive disorders were the most common diagnosis types for PCP visits without an eConsult order as well as bipolar disorder, but schizophrenia and psychotic disorder diagnoses were more common with eConsult orders. Over half of eConsults were for medication-related issues, 33% for a specific mental health diagnosis, and 15% for psychiatry without any details. Most PCPs (63%) never ordered an eConsult but the top ten users of eConsults accounted for 46% of the total orders.
AHRQ-funded; HS025245.
Citation: Golberstein E, Joseph JM, Druss BG .
The use of psychiatric econsults in primary care.
J Gen Intern Med 2020 Feb;35(2):616-17. doi: 10.1007/s11606-019-05048-w..
Keywords: Telehealth, Health Information Technology (HIT), Behavioral Health, Primary Care: Models of Care, Primary Care, Healthcare Delivery
Sorkin DH, Rizzo S, Biegler K
AHRQ Author: Ngo-Metzger Q
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
This article describes a multicomponent health information technology screening tool designed to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder (PTSD) in the primary care setting, with an eye toward meeting the mental health needs of traumatized refugees in the US Cambodian community. In a randomized controlled trial, 18 primary care providers were randomized to receive access to the mental health screening intervention, or to a minimal intervention control group. Cambodian American patients empaneled to participating providers were assigned to the providers' randomized group. From the results, the authors conclude that this approach offers the potential for training providers to diagnose and treat traumatized patients seeking mental health care in primary care.
AHRQ-authored.
Citation: Sorkin DH, Rizzo S, Biegler K .
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S190-s96. doi: 10.1097/mlr.0000000000001036..
Keywords: Depression, Diagnostic Safety and Quality, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Racial and Ethnic Minorities, Screening
Riley AR, Paternostro JK, Walker BL
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
This retrospective match-controlled study examined the impact of behavioral health consultations on medical visit duration in pediatric primary care. Patient encounters involving behavioral health consultants were significantly longer (11 plus minutes) than matched controls, and had less time allowed for medical care. The authors of the study recommend that behavioral health consultants work with the clinician to improve time efficiency.
AHRQ-funded; HS022981.
Citation: Riley AR, Paternostro JK, Walker BL .
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
Fam Syst Health 2019 Jun;37(2):162-66. doi: 10.1037/fsh0000406..
Keywords: Behavioral Health, Children/Adolescents, Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care
Riley AR, Freeman KA
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
This commentary discusses the role that behavioral analysts can have in partnership with pediatric medicine. There have been advances, but there has been limited impact for the daily practice of pediatrics. The authors discuss why behavioral pediatrics has failed to gain traction in primary care, describe possible opportunities for an expanded portfolio of research, and identify several examplars from the behavior analytic literature that has influenced pediatric primary care, and make further recommendations for producing influential data.
AHRQ-funded; HS022981.
Citation: Riley AR, Freeman KA .
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
Behav Anal 2019 Feb;19(1):23-38. doi: 10.1037/bar0000114..
Keywords: Behavioral Health, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care, Research Methodologies
Yonek JC, Jordan N, Dunlop D
Patient-centered medical home care for adolescents in need of mental health treatment.
The patient-centered medical home (PCMH) has emerged as an optimal primary care model for all youth; however, little is known about the extent to which adolescents in need of mental health (MH) treatment receive care consistent with the PCMH. This study assessed (1) 10-year trends in PCMH care among U.S. adolescents according to MH need and (2) variations in PCMH care and its subcomponents among adolescents with MH need, by individual and family characteristics.
AHRQ-funded; HS024183.
Citation: Yonek JC, Jordan N, Dunlop D .
Patient-centered medical home care for adolescents in need of mental health treatment.
J Adolesc Health 2018 Aug;63(2):172-80. doi: 10.1016/j.jadohealth.2018.02.006..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening
Hubley S, Uebelacker LA, Nash J
Open trial of integrated primary care consultation for medically unexplained symptoms.
In this study, a behavioral consultation intervention for primary care patients with medically unexplained symptoms (n = 10) was developed and assessed. Notwithstanding the limitations of open trial designs, the findings demonstrated high feasibility for a behavioral health consultation treatment model for patients with medically unexplained symptoms and highlight the need for further research.
AHRQ-funded; HS022401.
Citation: Hubley S, Uebelacker LA, Nash J .
Open trial of integrated primary care consultation for medically unexplained symptoms.
J Behav Health Serv Res 2017 Oct;44(4):590-601. doi: 10.1007/s11414-016-9528-5..
Keywords: Behavioral Health, Primary Care, Primary Care: Models of Care
Kass AE, Balantekin KN, Fitzsimmons-Craft EE
The economic case for digital interventions for eating disorders among United States college students.
This article aimed to estimate the costs, in United States (US) dollars, of a stepped care model for online prevention and treatment among US college students to inform meaningful decisions regarding resource allocation and adoption of efficient care delivery models for EDs on college campuses. A stepped care model was estimated to achieve modest cost savings compared to standard care, but these estimates need to be tested with sensitivity analyses.
AHRQ-funded; HS000078.
Citation: Kass AE, Balantekin KN, Fitzsimmons-Craft EE .
The economic case for digital interventions for eating disorders among United States college students.
Int J Eat Disord 2017 Mar;50(3):250-58. doi: 10.1002/eat.22680.
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Keywords: Behavioral Health, Healthcare Delivery, Healthcare Costs, Prevention, Primary Care: Models of Care, Telehealth, Young Adults, Web-Based
Davis MM, Balasubramanian BA, Cifuentes M
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
This study examined the interrelationship among behavioral health clinician staffing, scheduling, and a primary care practice's approach to delivering integrated care. It concluded that practices' approaches to staffing by primary care clinicians and behavioral health clinicians, scheduling, and delivery of integrated care mutually influenced each other and were shaped by the local context.
AHRQ-funded; HS022981.
Citation: Davis MM, Balasubramanian BA, Cifuentes M .
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S32-40. doi: 10.3122/jabfm.2015.S1.150087.
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Keywords: Behavioral Health, Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Community-Based Practice
Hall J, Cohen DJ, Davis M
Preparing the workforce for behavioral health and primary care integration.
The researchers sought to identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. They concluded that insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration. Until the training capacity grows to meet the demand, practices must put forth considerable effort and resources to train their own employees.
AHRQ-funded; HS022981.
Citation: Hall J, Cohen DJ, Davis M .
Preparing the workforce for behavioral health and primary care integration.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S41-51. doi: 10.3122/jabfm.2015.S1.150054.
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Keywords: Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Behavioral Health, Training, Community-Based Practice