Providing Health Physicals and/or Health Monitoring Services in Mental Health Clinics: Impact on Laboratory Screening and Monitoring for High Risk Populations.
Providing Health Physicals and/or Health Monitoring Services in Mental Health Clinics: Impact on Laboratory Screening and Monitoring for High Risk Populations.
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DOI：
10.1007/s10488-020-01071-w
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Finnerty M
中科院分区：
文献类型：
--
作者：
Breslau J;Leckman-Westin E;Han B;Guarasi D;Yu H;Horvitz-Lennon M;Pritam R;Finnerty M
在专业心理健康诊所提供身体健康护理是改善患有严重精神疾病的成年人健康状况的一种有希望的方法，但在以前的研究中检查的大多数项目在经济上是不可持续的。本研究评估了在纽约州实施的一项低成本计划对护理质量的影响，该计划允许医疗补助计划报销精神卫生诊所提供的健康监测和健康体检（HM/HP）。采用广义线性多水平模型分析医疗补助索赔数据，以检查与HM/HP服务相关的身体健康护理质量随时间的变化。将HM/HP服务的接受者与对照诊所患者（符合方案（PP））以及来自干预和对照诊所的HM/HP服务的非接受者（接受治疗（AT））进行比较。将HM/HP门诊患者（无论是否接受HM/HP服务）与对照门诊患者进行比较（意向治疗（ITT））。分析进行了调整患者的人口统计学和临床特征和前一年的服务使用。PP和AT分析发现，抗精神病药物治疗患者的血糖筛查指标和糖尿病患者的HbA 1C检测指标（AOR范围为1.26-1.33）显著改善，AT分析发现抗精神病药物治疗患者的胆固醇筛查指标显著改善（AOR=1.24）。然而，ITT分析发现，相对于对照诊所，HM/HP诊所病例量的护理质量没有显著变化。低成本的HM/HP计划有可能使接受支持服务的患者受益，但其影响受到服务实施的剩余障碍的限制。
Providing physical health care in specialty mental health clinics is a promising approach to improving the health status of adults with serious mental illness, but most programs examined in prior studies are not financially sustainable. This study assessed the impact on quality of care of a low-cost program implemented in New York State that allowed mental health clinics to be reimbursed by Medicaid for provision of health monitoring and health physicals (HM/HP). Medicaid claims data were analyzed with generalized linear multilevel models to examine change over time in quality of physical health care associated with HM/HP services. Recipients of HM/HP services were compared to control clinic patients (Per protocol (PP)) and with non-recipients of HM/HP services from both intervention and control clinics (As-Treated (AT)). HM/HP clinic patients, regardless of receipt of HM/HP services, were compared with control clinic patients (Intent-to-Treat (ITT)). Analyses were conducted with adjustment for patient demographic and clinical characteristics and prior year service use. The PP and AT analyses found significant improvement in measure of blood glucose screening for patients on antipsychotic medication and HbA1C testing for patients with diabetes (AOR range 1.26–1.33) and the AT analysis found significant improvement in cholesterol screening for patients on antipsychotic medication (AOR=1.24). However, ITT analysis found no significant changes in quality of care in HM/HP clinic caseloads relative to control clinics. The low-cost HM/HP program has the potential to benefit patients who receive supported services, but its impact is limited by remaining barriers to service implementation.
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影响因子：
2
作者：
Antonelli J;Han B;Cefalu M
通讯作者：
Cefalu M
影响因子：
2.7
作者：
Breslau, Joshua;Pritam, Riti;Leckman-Westin, Emily
通讯作者：
Leckman-Westin, Emily
影响因子：
3.8
作者：
Scharf, Deborah M.;Hackbarth, Nicole Schmidt;Burnam, M. Audrey
通讯作者：
Burnam, M. Audrey
影响因子：
1.9
作者：
Little, Roderick J.;Long, Qi;Lin, Xihong
通讯作者：
Lin, Xihong
影响因子：
--
作者：
Druss, BG;Rohrbaugh, RM;Rosenheck, RA
通讯作者：
Rosenheck, RA