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- Access to Care (2)
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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 14 of 14 Research Studies DisplayedOlfson M, Zuvekas SH, McClellan C
AHRQ Author: Zuvekas SH, McClellan C
Racial-ethnic disparities in outpatient mental health care in the United States.
Using data from the 2018-19 Medical Expenditure Panel Survey, researchers compared national rates and patterns of use for outpatient mental health care among Hispanic, non-Hispanic Black, and non-Hispanic White individuals. Analyses focused on individuals using psychotropic medications, psychotherapy, or both, and receipt of minimally adequate mental health care. The results showed that the rate of outpatient mental health service use was more than twice as high for White individuals, and that Black and Hispanic patients were significantly less likely to receive psychotropic medications; Black and Hispanic patients were more likely to receive psychotherapy. No significant differences were found in patients who received minimally adequate treatment for depression, anxiety, attention-deficit hyperactivity disorder, or disruptive behavior disorders. The authors concluded that achieving racial-ethnic equity will require dedicated efforts to promote greater mental health service access for Black and Hispanic persons in need.
AHRQ-authored.
Citation: Olfson M, Zuvekas SH, McClellan C .
Racial-ethnic disparities in outpatient mental health care in the United States.
Psychiatr Serv 2023 Jul; 74(7):674-83. doi: 10.1176/appi.ps.20220365..
Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Disparities, Behavioral Health, Ambulatory Care and Surgery
Yang J, Landrum MB, Zhou L
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
The purpose of this study was to examine changes in outpatient visits for mental health and/or substance use disorders (MH/SUD) in an integrated healthcare organization during the initial Massachusetts COVID-19 surge and partial state reopening. The investigators concluded that MH/SUD visit volume increased during the COVID surge and was supported by rapidly-scaled telemedicine.
AHRQ-funded; HS025375.
Citation: Yang J, Landrum MB, Zhou L .
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
Gen Hosp Psychiatry 2020 Nov-Dec;67:100-06. doi: 10.1016/j.genhosppsych.2020.09.004..
Keywords: Behavioral Health, Substance Abuse, COVID-19, Disparities, Access to Care, Ambulatory Care and Surgery, Telehealth, Health Information Technology (HIT)
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
Rhee TG, Olfson M, Nierenberg AA
20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings.
Pharmacological options for treating bipolar disorder have increased over the past 20 years, with several second-generation antipsychotics receiving regulatory approval in the 1990s. In this study the authors describe trends in use of pharmacological agents in the outpatient management of bipolar disorder. The authors concluded that substantial changes occurred in the treatment of bipolar disorder over the past 20 years, with second-generation antipsychotics in large measure supplanting traditional mood stabilizers.
AHRQ-funded; HS023000.
Citation: Rhee TG, Olfson M, Nierenberg AA .
20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings.
Am J Psychiatry 2020 Aug;177(8):706-15. doi: 10.1176/appi.ajp.2020.19091000..
Keywords: Behavioral Health, Medication, Practice Patterns, Ambulatory Care and Surgery, Provider: Physician, Provider
Samples H, Stuart EA, Saloner B
The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits.
This study aimed to examine depression screening patterns and the role of screening in depression diagnosis and treatment in the outpatient primary care setting. The investigators found that physicians appeared to use depression screening selectively based on patients' presenting symptoms. Higher screening rates were associated with higher odds of depression diagnosis and treatment. The investigators suggest that even modest increases in screening rates could meaningfully increase population-level rates of depression identification and treatment in primary care.
AHRQ-funded; HS000029.
Citation: Samples H, Stuart EA, Saloner B .
The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits.
J Gen Intern Med 2020 Jan;35(1):12-20. doi: 10.1007/s11606-019-05192-3..
Keywords: Depression, Behavioral Health, Diagnostic Safety and Quality, Primary Care, Screening, Ambulatory Care and Surgery
McKernan LC, Lenert MC, Crofford LJ
Outpatient engagement and predicted risk of suicide attempts in fibromyalgia.
Patients with fibromyalgia (FM) are 10 times more likely to die by suicide than the general population. The purpose of this study was to externally validate published models predicting suicidal ideation and suicide attempts in patients with FM and to identify interpretable risk and protective factors for suicidality unique to FM. This was the first study to successfully apply machine learning to reliably detect suicidality in patients with FM, identifying novel risk factors for suicidality and highlighting outpatient engagement as a protective factor against suicide.
AHRQ-funded; HS022990.
Citation: McKernan LC, Lenert MC, Crofford LJ .
Outpatient engagement and predicted risk of suicide attempts in fibromyalgia.
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Keywords: Patient and Family Engagement, Risk, Behavioral Health, Ambulatory Care and Surgery
Cherrington AL, Khodneva Y, Richman JS
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
This study examined the impact of peer support on the number of acute care visits and hospitalizations for individuals with diabetes with and without depressive symptoms. This randomized controlled trial was conducted from 2010-2012. One year of peer support was given to intervention participants, and the usual care to control participants. A Patient Health Questionnaire (PHQ-8) was given to participants to assess depression symptoms at the beginning of the trial, at 6 months and then at 12 months. There was a lower rate of acute care visits and hospitalizations in those patients with depressive symptoms in the intervention group, but it made no difference for individuals without depressive symptoms.
AHRQ-funded; HS013852.
Citation: Cherrington AL, Khodneva Y, Richman JS .
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
Diabetes Care 2018 Dec;41(12):2463-70. doi: 10.2337/dc18-0550..
Keywords: Ambulatory Care and Surgery, Chronic Conditions, Depression, Diabetes, Hospitalization, Behavioral Health, Patient Self-Management
Beebe L, Smith KD, Oppizzi LM
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
In this study, the investigators conducted a descriptive analysis of data gathered during calls to 87 stable outpatients with schizophrenia spectrum disorders, receiving weekly telephone intervention-problem solving (TIPS) for nine months. The investigators suggest that their findings regarding racial differences in antipsychotic delivery method warrant further investigation.
AHRQ-funded; HS022166.
Citation: Beebe L, Smith KD, Oppizzi LM .
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
Issues Ment Health Nurs 2018 Jul;39(7):561-67. doi: 10.1080/01612840.2018.1431824..
Keywords: Ambulatory Care and Surgery, Medication, Behavioral Health, Patient Adherence/Compliance
Kohler-Forsberg O, Madsen T, Behrendt-Moller I
Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.
The researchers aimed to investigate 6-months trajectories of suicidal ideation among adults with bipolar disorder. Using data from the Bipolar CHOICE study, they identified four distinct trajectories and found that more than one in ten adult outpatients with bipolar disorder had moderately increased suicidal ideation throughout 6 months of pharmacotherapy. They recommended that the identified predictors may help clinicians to identify those with additional need for treatment against suicidal thoughts, and future studies need to investigate whether targeted treatment may improve the course of persistent suicidal ideation.
AHRQ-funded; HS019371.
Citation: Kohler-Forsberg O, Madsen T, Behrendt-Moller I .
Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.
J Affect Disord 2017 Dec 1;223:146-52. doi: 10.1016/j.jad.2017.07.038.
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Keywords: Behavioral Health, Medication, Ambulatory Care and Surgery, Patient-Centered Healthcare
Gallo KP, Olin SS, Storfer-Isser A
Parent burden in accessing outpatient psychiatric services for adolescent depression in a large state system.
This study examined barriers facing parents who seek outpatient psychiatric care in a large state system for adolescents with depression. It found that virtually all clinics required at least one intake or therapy appointment before receipt of a psychiatry appointment. Parental burden did not differ by region, urbanicity, clinic type, seasonality (spring or summer), or insurance status.
AHRQ-funded; HS020503.
Citation: Gallo KP, Olin SS, Storfer-Isser A .
Parent burden in accessing outpatient psychiatric services for adolescent depression in a large state system.
Psychiatr Serv 2017 Apr;68(4):411-14. doi: 10.1176/appi.ps.201600111.
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Keywords: Access to Care, Children/Adolescents, Depression, Behavioral Health, Ambulatory Care and Surgery
Carney RM, Freedland KE, Steinmeyer BC
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
The purpose of this study was to determine whether collaborative care (CC) for patients who screen positive for depression during an outpatient cardiology visit results in greater improvement in depression symptoms and better medical outcomes than seen in patients who screen positive for depression but receive only usual care (UC). Tthis trial did not show that CC produces better depression outcomes than UC.
AHRQ-funded; HS018335.
Citation: Carney RM, Freedland KE, Steinmeyer BC .
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
Int J Cardiol 2016 Sep 15;219:164-71. doi: 10.1016/j.ijcard.2016.06.045.
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Keywords: Care Management, Cardiovascular Conditions, Depression, Healthcare Delivery, Behavioral Health, Outcomes, Ambulatory Care and Surgery, Teams
Bickman L, Douglas SR, De Andrade AR
Implementing a measurement feedback system: a tale of two sites.
A randomized experiment was conducted in two outpatient clinics evaluating contextualized feedback systems. Only one of the two participating clinics had an enhanced outcome because of feedback. Clinicians' questionnaire completion rate and feedback viewing were 50 % higher at this clinic. The discussion focused on the differences in implementation at each site and how these differences may have contributed to the different outcomes of the experiment.
AHRQ-funded; HS018036.
Citation: Bickman L, Douglas SR, De Andrade AR .
Implementing a measurement feedback system: a tale of two sites.
Adm Policy Ment Health 2016 May;43(3):410-25. doi: 10.1007/s10488-015-0647-8.
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Keywords: Behavioral Health, Outcomes, Ambulatory Care and Surgery, Patient-Centered Healthcare
Olfson M, Druss BG, Marcus SC
Trends in mental health care among children and adolescents.
This study examined national trends in the use of outpatient mental health services by children and adolescents, focusing on the severity of mental health impairment. It found that outpatient mental health treatment and psychotropic-medication use in children and adolescents increased in the United States between 1996–1998 and 2010–2012. Youths with less severe or no impairment accounting for most of the absolute increase in service use.
AHRQ-funded; HS021112.
Citation: Olfson M, Druss BG, Marcus SC .
Trends in mental health care among children and adolescents.
N Engl J Med 2015 May 21;372(21):2029-38. doi: 10.1056/NEJMsa1413512..
Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Ambulatory Care and Surgery
Beadles CA, Ellis AR, Lichstein JC
First outpatient follow-up after psychiatric hospitalization: does one size fit all?
This study examined the timing of first outpatient follow-up and subsequent health care utilization for adults with serious mental illness (major depression or schizophrenia) and comorbid general medical conditions. It found that for patients not readmitted within 30 days, follow-up within 30 days appeared to be beneficial on the basis of subsequent service utilization.
AHRQ-funded; HS019659; HS000032.
Citation: Beadles CA, Ellis AR, Lichstein JC .
First outpatient follow-up after psychiatric hospitalization: does one size fit all?
Psychiatr Serv 2015 Apr;66(4):364-72. doi: 10.1176/appi.ps.201400081..
Keywords: Hospitalization, Behavioral Health, Healthcare Utilization, Ambulatory Care and Surgery