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Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness

INTRODUCTION: Efficacy trials have shown that primary care co-located in the mental health setting improves the receipt of high-quality medical care among people with serious mental illness. We tested whether implementation of such a program affected health service use and cardiovascular risk factor...

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Autores principales: Pirraglia, Paul A., Rowland, Emily, Wu, Wen-Chih, Friedmann, Peter D., O'Toole, Thomas P., Cohen, Lisa B., Taveira, Tracey H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Centers for Disease Control and Prevention 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340211/
https://www.ncbi.nlm.nih.gov/pubmed/22300871
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author Pirraglia, Paul A.
Rowland, Emily
Wu, Wen-Chih
Friedmann, Peter D.
O'Toole, Thomas P.
Cohen, Lisa B.
Taveira, Tracey H.
author_facet Pirraglia, Paul A.
Rowland, Emily
Wu, Wen-Chih
Friedmann, Peter D.
O'Toole, Thomas P.
Cohen, Lisa B.
Taveira, Tracey H.
author_sort Pirraglia, Paul A.
collection PubMed
description INTRODUCTION: Efficacy trials have shown that primary care co-located in the mental health setting improves the receipt of high-quality medical care among people with serious mental illness. We tested whether implementation of such a program affected health service use and cardiovascular risk factor control among veterans with serious mental illness who had previously demonstrated limited primary care engagement. METHODS: We performed a cohort study of veterans enrolled in a co-located, integrated primary care clinic in the mental health outpatient unit through targeted chart review. Two successive 6-month periods in the year before and in the year following enrollment in the co-located primary care clinic were examined for primary care and emergency department use and for goal attainment of blood pressure, fasting blood lipids, body mass index (BMI), and, among patients with diabetes, hemoglobin A1c (HbA1c). We used repeated-measures logistic regression to analyze goal attainment and repeated measures Poisson regression to analyze service use. RESULTS: Compared with the period before enrollment, the 97 veterans enrolled in the clinic had significantly more primary care visits during 6 months and significantly improved goal attainment for blood pressure, low-density lipoprotein cholesterol, triglycerides, and BMI. Changes with regard to goal attainment for high-density lipoprotein cholesterol and HbA1c were not significant. CONCLUSION: Enrollment in a co-located, integrated clinic was associated with increased primary care use and improved attainment of some cardiovascular risk goals among veterans with serious mental illness. Such a clinic can be implemented effectively in the mental health setting.
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spelling pubmed-33402112012-05-11 Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness Pirraglia, Paul A. Rowland, Emily Wu, Wen-Chih Friedmann, Peter D. O'Toole, Thomas P. Cohen, Lisa B. Taveira, Tracey H. Prev Chronic Dis Original Research INTRODUCTION: Efficacy trials have shown that primary care co-located in the mental health setting improves the receipt of high-quality medical care among people with serious mental illness. We tested whether implementation of such a program affected health service use and cardiovascular risk factor control among veterans with serious mental illness who had previously demonstrated limited primary care engagement. METHODS: We performed a cohort study of veterans enrolled in a co-located, integrated primary care clinic in the mental health outpatient unit through targeted chart review. Two successive 6-month periods in the year before and in the year following enrollment in the co-located primary care clinic were examined for primary care and emergency department use and for goal attainment of blood pressure, fasting blood lipids, body mass index (BMI), and, among patients with diabetes, hemoglobin A1c (HbA1c). We used repeated-measures logistic regression to analyze goal attainment and repeated measures Poisson regression to analyze service use. RESULTS: Compared with the period before enrollment, the 97 veterans enrolled in the clinic had significantly more primary care visits during 6 months and significantly improved goal attainment for blood pressure, low-density lipoprotein cholesterol, triglycerides, and BMI. Changes with regard to goal attainment for high-density lipoprotein cholesterol and HbA1c were not significant. CONCLUSION: Enrollment in a co-located, integrated clinic was associated with increased primary care use and improved attainment of some cardiovascular risk goals among veterans with serious mental illness. Such a clinic can be implemented effectively in the mental health setting. Centers for Disease Control and Prevention 2012-02-02 /pmc/articles/PMC3340211/ /pubmed/22300871 Text en https://creativecommons.org/licenses/by/4.0/This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
spellingShingle Original Research
Pirraglia, Paul A.
Rowland, Emily
Wu, Wen-Chih
Friedmann, Peter D.
O'Toole, Thomas P.
Cohen, Lisa B.
Taveira, Tracey H.
Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness
title Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness
title_full Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness
title_fullStr Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness
title_full_unstemmed Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness
title_short Benefits of a Primary Care Clinic Co-Located and Integrated in a Mental Health Setting for Veterans With Serious Mental Illness
title_sort benefits of a primary care clinic co-located and integrated in a mental health setting for veterans with serious mental illness
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340211/
https://www.ncbi.nlm.nih.gov/pubmed/22300871
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