Veterans Health Administration Investments In Primary Care And Mental Health Integration Improved Care Access

Health Affairs
Lucinda B LeungRanak B Trivedi

Abstract

Aiming to increase care access, the national Primary Care-Mental Health Integration (PC-MHI) initiative of the Veterans Health Administration (VHA) embedded specialists, care managers, or both in primary care clinics to collaboratively care for veterans with psychiatric illness. The initiative's effects on health care use and cost patterns were examined among 5.4 million primary care patients in 396 VHA clinics in 2013-16. The median rate of patients who saw a PC-MHI provider was 6.3 percent. Each percentage-point increase in the proportion of clinic patients seen by these providers was associated with 11 percent more mental health and 40 percent more primary care visits but also with 9 percent higher average total costs per patient per year. At the mean, 2.5 integrated care visits substituted for each specialty-based mental health visit that did not occur. PC-MHI was associated with improved access to outpatient care, albeit at increased total cost to the VHA. Successful implementation of integrated care necessitates significant investment and multidisciplinary partnership within health systems.

References

Feb 7, 2001·Archives of General Psychiatry·A S YoungK B Wells
Apr 26, 2002·Journal of General Internal Medicine·David E GrembowskiHarold I Goldberg
Jan 21, 2006·Journal of General Internal Medicine·David W OslinIra R Katz
Dec 20, 2008·Health Economics·Michael K ChapkoMatthew L Maciejewski
Aug 11, 2010·Families, Systems & Health : the Journal of Collaborative Family Healthcare·Edward P PostLaurent Lehmann
Aug 11, 2010·Families, Systems & Health : the Journal of Collaborative Family Healthcare·Lisa V RubensteinSusan Vivell
Aug 11, 2010·Families, Systems & Health : the Journal of Collaborative Family Healthcare·Andrew S PomerantzDebra Scott
Jan 7, 2011·Journal of Clinical Epidemiology·Joshua J GagneSebastian Schneeweiss
Apr 5, 2011·Psychiatric Services : a Journal of the American Psychiatric Association·Paul N PfeifferJohn F McCarthy
Nov 15, 2012·Journal of General Internal Medicine·Benjamin R SzymanskiJohn F McCarthy
Feb 3, 2015·Psychiatric Services : a Journal of the American Psychiatric Association·Rachel KimerlingSusan M Frayne
Jun 2, 2015·Psychiatric Services : a Journal of the American Psychiatric Association·David J Katzelnick, Mark D Williams
Oct 2, 2015·Psychiatric Services : a Journal of the American Psychiatric Association·Kipling M BohnertJohn F McCarthy
Oct 17, 2015·American Journal of Public Health·Ranak B TrivediKarin Nelson
Aug 24, 2016·JAMA : the Journal of the American Medical Association·Brenda Reiss-BrennanBrent James
Sep 13, 2016·International Journal of Integrated Care·Sofie Johanna Maria van HoofDirk Ruwaard
Aug 19, 2017·BMC Health Services Research·Jean Yoon, Adam Chow
Aug 29, 2017·JAMA Internal Medicine·Katherine E WatkinsHarold Alan Pincus
Dec 16, 2017·Psychiatric Services : a Journal of the American Psychiatric Association·Lucinda B LeungLisa V Rubenstein
Jan 14, 2018·Journal of the American Board of Family Medicine : JABFM·Lucinda B LeungJosé J Escarce
Feb 10, 2018·Journal of General Internal Medicine·Beth WaitzfelderGregory E Simon

❮ Previous
Next ❯

Citations

Sep 6, 2019·Journal of General Internal Medicine·Lucinda B LeungLisa V Rubenstein
Aug 6, 2020·Military Medicine·Jeffrey MilleganBernardo Buenviaje
Nov 20, 2019·Health Services Research·Megan B ColeMegan H Bair-Merritt
Feb 1, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Nicholas B FrischTad L Gerlinger
Jun 22, 2021·Medical Care·Laura A GrahamMelanie S Morris
Oct 5, 2021·Annals of Internal Medicine·Ryan CrowleyUNKNOWN Health and Public Policy Committee of the American College of Physicians*

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.