Five-Year Outcomes of Behavioral Health Integration in Pediatric Primary Care.


Journal

Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422

Informations de publication

Date de publication:
07 2019
Historique:
accepted: 08 03 2019
pubmed: 13 6 2019
medline: 18 12 2019
entrez: 13 6 2019
Statut: ppublish

Résumé

In the context of protracted shortages of pediatric behavioral health (BH) specialists, BH integration in pediatric primary care can increase access to BH services. The objectives of this study were to assess the structure and process of pediatric BH integration and outcomes in patient experience (access and quality), cost, and provider satisfaction. In 2013, we launched a multicomponent, transdiagnostic integrated BH model (Behavioral Health Integration Program [BHIP]) in a large pediatric primary care network in Massachusetts. Study participants comprised the first 13 practices to enroll in BHIP (Phase-1). Phase-1 practices are distributed across Greater Boston, with ∼105 primary care practitioners serving ∼114 000 patients. Intervention components comprised in-depth BH education, on-demand psychiatric consultation, operational support for integrated practice transformation, and on-site clinical BH service. Over 5 years, BHIP was associated with increased practice-level BH integration ( Findings from this study suggest that integrating BH in the pediatric setting can increase access to quality BH services while engendering provider confidence and satisfaction and averting substantial increases in cost.

Sections du résumé

BACKGROUND AND OBJECTIVES
In the context of protracted shortages of pediatric behavioral health (BH) specialists, BH integration in pediatric primary care can increase access to BH services. The objectives of this study were to assess the structure and process of pediatric BH integration and outcomes in patient experience (access and quality), cost, and provider satisfaction.
METHODS
In 2013, we launched a multicomponent, transdiagnostic integrated BH model (Behavioral Health Integration Program [BHIP]) in a large pediatric primary care network in Massachusetts. Study participants comprised the first 13 practices to enroll in BHIP (Phase-1). Phase-1 practices are distributed across Greater Boston, with ∼105 primary care practitioners serving ∼114 000 patients. Intervention components comprised in-depth BH education, on-demand psychiatric consultation, operational support for integrated practice transformation, and on-site clinical BH service.
RESULTS
Over 5 years, BHIP was associated with increased practice-level BH integration (
CONCLUSIONS
Findings from this study suggest that integrating BH in the pediatric setting can increase access to quality BH services while engendering provider confidence and satisfaction and averting substantial increases in cost.

Identifiants

pubmed: 31186366
pii: peds.2018-3243
doi: 10.1542/peds.2018-3243
pii:
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2019 by the American Academy of Pediatrics.

Déclaration de conflit d'intérêts

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Auteurs

Heather J Walter (HJ)

Departments of Psychiatry, heather.walter@childrens.harvard.edu.
Pediatric Physicians' Organization at Children's Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; and.

Louis Vernacchio (L)

Pediatric Physicians' Organization at Children's Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; and.
Pediatrics, and.

Emily K Trudell (EK)

Pediatric Physicians' Organization at Children's Hospital, Boston, Massachusetts.

Jonas Bromberg (J)

Departments of Psychiatry.
Pediatric Physicians' Organization at Children's Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; and.

Ellen Goodman (E)

Pediatric Physicians' Organization at Children's Hospital, Boston, Massachusetts.
Social Work, Boston Children's Hospital, Boston, Massachusetts.

Jessica Barton (J)

Pediatric Physicians' Organization at Children's Hospital, Boston, Massachusetts.
Social Work, Boston Children's Hospital, Boston, Massachusetts.

Gregory J Young (GJ)

Pediatric Physicians' Organization at Children's Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; and.
Pediatrics, and.

David R DeMaso (DR)

Departments of Psychiatry.
Harvard Medical School, Boston, Massachusetts; and.

Glenn Focht (G)

Connecticut Children's Medical Center, Hartford, Connecticut.

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