A Model to Improve Behavioral Health Integration into Serious Illness Care
A Model to Improve Behavioral Health Integration into Serious Illness Care
复制标题
DOI：
10.1016/j.jpainsymman.2019.05.017
复制
发表时间：
2019-09-01
影响因子：
4.7
通讯作者：
Pincus, Harold Alan
中科院分区：
文献类型：
--
作者：
Cheung, Stephanie;Spaeth-Rublee, Brigitta;Pincus, Harold Alan
行为健康问题在患有严重疾病的人中非常普遍。患有这些合并症的个体具有复杂的临床和社会需求，但面临孤立的护理，高医疗保健成本和不良结局。相互作用的因素导致这些不平等，包括历史上的行为和身体健康的提供分离。已经开发和测试了几种整合行为健康和一般医疗保健的护理模式，但证据基础主要集中在初级保健人群和环境上。本文通过提出一个行为健康-重病护理模式来推进这项工作。通过结合文献综述，调查，访谈和专家咨询小组的输入的混合方法开发，它提供了一个概念框架的积木行为健康整合量身定制的严重疾病护理人群和他们接受护理的设置范围。该模型旨在作为基础，以支持综合行为健康和严重疾病护理的发展和实施。该模型的关键组成部分进行了说明，讨论了实施的障碍，并提出了解决这些障碍的政策方法的建议。(C)2019年美国临终关怀和姑息医学学院。爱思唯尔公司出版All rights reserved.
Behavioral health problems are highly prevalent among people with serious medical illness. Individuals living with these comorbidities have complex clinical and social needs yet face siloed care, high health care costs, and poor outcomes. Interacting factors contribute to these inequalities including historical separation of behavioral and physical health provision. Several care models for integrating behavioral health and general medical care have been developed and tested, but the evidence base focuses primarily on primary care populations and settings. This article advances that work by proposing a Behavioral Health-Serious Illness Care model. Developed through a mixed methods approach combining literature review, surveys, interviews, and input from an expert advisory panel, it provides a conceptual framework of building blocks for behavioral health integration tailored to serious illness care populations and the range of settings in which they receive care. The model is intended to serve as foundation to support the development and implementation of integrated behavioral health and serious illness care. The key components of the model are described, barriers to implementation discussed, and recommendations for policy approaches to address these barriers presented. (C) 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.