Integrating Behavioral Health Services at Employer-Sponsored Health Clinics: A Descriptive Analysis
Integrating Behavioral Health Services at Employer-Sponsored Health Clinics: A Descriptive Analysis
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DOI：
10.1037/fsh0000545
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发表时间：
2020-12-01
影响因子：
1.3
通讯作者：
Bravata, Dena M.
中科院分区：
文献类型：
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作者：
Wright, John R.;Hagg, Heather K.;Bravata, Dena M.
简介：在美国，大约20%的成年人有行为健康问题，导致7.32亿美元的直接医疗支出和每年超过500万个工作日的损失。雇主承担了这些费用的很大一部分。本研究的目的是描述行为健康服务在雇主赞助的健康诊所的整合。方法：回顾性队列分析2018年1月1日至2018年12月31日在雇主资助诊所接受个体行为健康服务的患者。结果：在行为健康提供者照顾的2,954名患者中，49%符合中度或重度抑郁和/或焦虑的标准。预约和行为健康分诊之间的中位时间间隔为2天（SD = 7.2天），初始心理治疗访问的中位时间间隔为10天（SD = 14天）。在就诊后最初3个月内，与行为健康提供者的平均就诊次数为5.3次（SD = 2.8次）。在治疗过程中，焦虑（广泛性焦虑障碍-7 [GAD-7]评分）下降了31%，抑郁（患者健康问卷-9 [PHQ-9]评分）下降了24%。患者对他们的行为保健服务的满意度非常高。讨论：将行为健康服务纳入雇主赞助的诊所可以及时获得心理治疗，改善临床症状，并提高患者满意度。有意提供更多行为保健服务的雇主应评估将此类服务纳入现场或附近的健康诊所。
Introduction: Approximately, 20% of adults in the United States have a behavioral health concern, resulting in $732M in direct medical spending and over 5 million lost workdays annually. Employers bear a substantial share of these costs. The objective of this study was to describe the integration of behavioral health services at employer-sponsored health clinics. Method: Retrospective cohort analysis of patients seen for individual behavioral health services from 1/1/2018 to 12/31/2018 in employer-sponsored clinics. Results: Among the 2,954 patients cared for by a behavioral health provider, 49% met criteria for moderate or severe depression and/or anxiety. The median duration between appointment scheduling and a behavioral health triage visit was 2 days (SD = 7.2 days), and median interval to an initial psychotherapy visit was 10 days (SD = 14 days). The mean number of visits with a behavioral health provider within the initial 3 months after presenting for care was 5.3 visits (SD = 2.8 visits). During the course of treatment, anxiety (Generalized Anxiety Disorder-7 [GAD-7] scores) decreased by 31% and depression (Patient Health Questionnaire-9 [PHQ-9] scores) decreased by 24%. Patient satisfaction with their behavioral health care was excellent. Discussion: Integrating behavioral health services into employer-sponsored clinics can result in timely access to psychotherapy, improvements in clinical symptoms, and excellent patient satisfaction. Employers interested in providing greater access to behavioral health care should evaluate integrating such services into onsite or near-site health clinics.