Abstract：
OBJECTIVE:Integrating primary care services into specialty mental health clinics has been proposed as a method for improving health care utilization for medical conditions by adults with serious mental illness. This paper examines the impact of a mental health based primary care program on emergency department (ED) visits and hospitalizations. METHOD:The program was implemented in seven New York City outpatient mental health clinics in two waves. Medicaid claims were used to identify patients treated in intervention clinics and a control group of patients treated in otherwise similar clinics in New York City. Impacts of the program were estimated using propensity score adjusted difference-in-differences models on a longitudinally followed cohort. RESULTS:Hospital stays for medical conditions increased significantly in intervention clinics relative to control clinics in both waves (ORs = 1.21 (Wave 1) and 1.33 (Wave 2)). ED visits for behavioral health conditions decreased significantly relative to controls in Wave 1 (OR = 0.89), but not in Wave 2. No other significant differences in utilization trends between the intervention and control clinics were found. CONCLUSION:Introducing primary care services into mental health clinics may increase utilization of inpatient services, perhaps due to newly identified unmet medical need in this population.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Breslau J,Leckman-Westin E,Han B,Pritam R,Guarasi D,Horvitz-Lennon M,Scharf DM,Finnerty MT,Yu Hdoi
10.1016/j.genhosppsych.2018.02.008subject
Has Abstractpub_date
2018-01-01 00:00:00pages
8-13eissn
0163-8343issn
1873-7714pii
S0163-8343(17)30534-0journal_volume
52pub_type
杂志文章abstract：BACKGROUND:Psychological morbidity in both patients and family members related to the intensive care unit (ICU) experience is an often overlooked, and potentially persistent, healthcare problem recognized by the Society of Critical Care Medicine as Post-intensive Care Syndrome (PICS). ICU diaries are an intervention in...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2020.06.017
更新日期：2020-01-01 00:00:00
abstract：:In the Netherlands, the prescription of beta-blockers to patients older than 70 years has increased sharply in recent years. The neuropsychiatric adverse reactions associated with the use of beta-blockers are relatively uncommon and they are mostly seen with poisoning or overdose. We describe an 81-year-old man who de...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.04.008
更新日期：2010-11-01 00:00:00
abstract：:This study examines the recognition and treatment of emotional distress in physically healthy primary care patients who perceive themselves to be in fair or poor physical health. Patients (N = 892) from three private primary care practices completed a mental health screening form prior to their medical visit which inc...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(95)00023-k
更新日期：1995-05-01 00:00:00
abstract：OBJECTIVE:Despite a good prognosis, the typically young age at diagnosis and physical sequelae may cause psychological distress in germ cell tumor survivors. We aimed to determine the frequency of anxiety and depression and analyze the impact of demographic and disease-related factors. METHOD:We enrolled N=164 testicu...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.09.001
更新日期：2016-01-01 00:00:00
abstract：:Drawing on experiences as a Physician Advisor to the Office of Quality Assurance of the American Psychiatric Association, the author discusses process interactions endemic to peer review and presents recommendations for facilitating this necessary professional activity. ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(89)90073-x
更新日期：1989-07-01 00:00:00
abstract：:A 63-year-old married man with idiopathic terminal cardiomyopathy was admitted to the medical service for treatment of advanced heart failure. A psychiatric consultation was requested to assist the medical treatment team in dealing with the patient's abusive behavior. The case is presented and discussed within the con...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(92)90099-v
更新日期：1992-07-01 00:00:00
abstract：:A study was conducted of all 51 patients admitted on 64 occasions with self-inflicted burns to the Welsh Regional Burns Unit between January 1979 and January 1991. Two different groups of patients were identified, namely, patients who attempted suicide and patients with self-mutilative behavior. Their differences on a...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(92)90007-w
更新日期：1992-11-01 00:00:00
abstract：:As part of a population study on the prevalence of psychopathology, users of "Over-The-Counter" Psychotropics (OTC-Ps) were studied. First, their mental health profile was examined by a number of subjective and objective assessments. Second, the medical consumption of the users was studied with special attention to th...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(00)00078-5
更新日期：2000-07-01 00:00:00
abstract：:To examine those patients referred to psychiatry for the "problem of coping," a structured clinical databased management system--MICRO-CARES--was employed to identify the frequency, demographic characteristics, psychiatric diagnoses, psychosocial interventions, use of psychopharmacology, number of follow-up visits, an...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(93)90084-2
更新日期：1993-01-01 00:00:00
abstract：:The ventral striatum has been assigned a major role in addictive behavior. In addition, clinical lesion studies have described involvement of the insula and globus pallidus. To the best of our knowledge, this is the first report of alleviation of alcohol and nicotine addiction after a cerebrovascular incident in the d...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.01.008
更新日期：2012-11-01 00:00:00
abstract：:Somatization is a common phenomenon that has been defined in many ways. The two most widely used diagnoses, Somatization Disorder (SD) and Abridged Somatization Disorder (ASD), are based on lifetime unexplained symptoms. However, reports indicate instability in lifetime symptom recall among somatizing patients. Multis...
journal_title：General hospital psychiatry
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0163-8343(02)00247-5
更新日期：2003-01-01 00:00:00
abstract：:The purpose of this pretest-posttest study was to evaluate effects of a training program designed to improve primary care physicians' (PCPs) ability to recognize mental health problems (MHP) and to diagnose and manage depression according to clinical guidelines. The primary care settings were in the northern part of T...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(98)00080-2
更新日期：1999-05-01 00:00:00
abstract：:The current study investigated differences in self-harm behavior among individuals with borderline personality symptomatology from two different clinical settings. Participants were women, between the ages of 18 and 45, from an outpatient mental health setting or a primary care setting. Each participant completed the ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(00)00074-8
更新日期：2000-05-01 00:00:00
abstract：:Outpatient consultation-liaison (C-L) psychiatry has been beset with problems concerning funding and patient acceptance. Though the consultation, liaison, and referral clinic models for outpatient C-L psychiatry each offer advantages, they have not conquered these fundamental problems. This paper introduces the multid...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(93)90005-9
更新日期：1993-11-01 00:00:00
abstract：OBJECTIVE:In recent years, patients' preferences concerning treatment of emotional distress in general and of depression in particular have received more emphasis in the clinical setting as well as in research. METHODS:The treatment preferences of 607 primary care patients were assessed in a cross-sectional study usin...
journal_title：General hospital psychiatry
pub_type： 评论,杂志文章
doi：10.1016/j.genhosppsych.2005.10.001
更新日期：2006-03-01 00:00:00
abstract：BACKGROUND:Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). OBJECTIVES:The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. DESIGN:PTSD at 30 months after the SARS ou...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.07.007
更新日期：2010-11-01 00:00:00
abstract：:Factitious disorder by proxy (FDP) is a form of abuse in which a caregiver surreptitiously simulates or induces illnesses in a person for whom he or she cares. Typically, a mother is the perpetrator and at least one of her children is victimized. FDP has a high morbidity and mortality rate, and a knowledgeable health ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(95)00127-1
更新日期：1996-03-01 00:00:00
abstract：:The authors surveyed 356 family medicine residency training directors to determine the role of psychiatrists in family medicine training. Two hundred five responses were received, covering the training experiences of 3696 residents. Psychiatrists were actively involved in the training programs, but their role was circ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(83)90111-1
更新日期：1983-07-01 00:00:00
abstract：:To test the hypothesis that depression is often inaccurately detected in medical settings, we examined the psychiatric consultations performed at two medical-surgical teaching hospitals. All records for the 4396 consultations seen in a 3-year period were retrospectively reviewed. Consultations were categorized by the ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(95)00089-5
更新日期：1996-01-01 00:00:00
abstract：:Eating disorders like bulimia nervosa, generally considered to be rare in Asian countries, are currently on the rise among the youth, probably secondary to rapid westernization and globalization of the orient. Clinical manifestations of these disorders, which were previously thought to be different in the oriental cou...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.05.006
更新日期：2014-09-01 00:00:00
abstract：:This article presents research involving the comparison of levels of occupational stress across multiple units of a large teaching hospital. Using a scale designed to measure a four-component model of occupational stress in medical environments, the results indicated that a significant amount of the variation in this ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(87)90053-3
更新日期：1987-11-01 00:00:00
abstract：OBJECTIVE:To describe the use of prescription drugs and their association with patient characteristics in patients with multiple functional somatic syndromes (FSS) focusing on drugs generally recommended and not recommended in FSS treatment. METHOD:Using data from a national prescription registry, we describe the drug...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.02.001
更新日期：2018-01-01 00:00:00
abstract：:Interviews with patients and staff of the New York Hospital Burn Unit in which they discuss their reactions to a variety of unit milieu stresses were videotaped. These were then edited together and played back at staff conference. This intervention increased staff awareness of unit stresses, facilitated discussion abo...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(86)90058-7
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVE:We investigated the effects of limited time and high patient pressures on the role of gender and other nonpsychiatric factors in diagnostic decision making in psychiatric emergency services (PES). METHODS:We reviewed the records of 1236 adult psychiatric patients treated by 75 clinicians (e.g., psychiatrists...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2007.08.008
更新日期：2007-11-01 00:00:00
abstract：OBJECTIVE:The goal of this paper was to examine the relationship between history of substance use disorder (SUD) and self-reported prescription medication misuse in 127 primary care patients who receive opioid medications for treatment of chronic pain. METHOD:Participants completed measures of pain location, pain inte...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2007.12.004
更新日期：2008-03-01 00:00:00
abstract：INTRODUCTION:Catatonia is classically associated with psychiatric conditions but may occur in medical and neurologic disorders. Status epilepticus (SE) is a seizure lasting more than five minutes or two or more seizures within a five-minute period without interictal recovery of consciousness. Non-convulsive status epil...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/j.genhosppsych.2020.11.008
更新日期：2021-01-01 00:00:00
abstract：OBJECTIVE:We investigated the views of service users and staff regarding contact-based interventions (e.g., letters, telephone calls or crisis cards) following self-harm. METHOD:Self-harm patients recently discharged from an emergency department were selected using purposive sampling (n=11). Clinical staff from releva...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.01.009
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine the effect of adjuvant light therapy with antipsychotic treatment in patients with delirium. METHODS:Thirty-six patients were referred to the consulting psychiatry division of our hospital for a disturbance in consciousness. The patients were randomized to risperido...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2012.05.003
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:The prevalence of depression in multiple sclerosis (MS) is known to be elevated, but nearly all available studies have estimated period prevalence. The objective of this study was to estimate the point prevalence of depression in a representative community sample using the Patient Health Questionnaire, Brief ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2013.12.011
更新日期：2014-05-01 00:00:00
abstract：:To ascertain how effective the Beck Depression Inventory for Primary Care (BDI-PC) was in screening for DSM-IV major depression disorders (MDD) in outpatients who were scheduled for routine office visits with physicians specializing in internal medicine, the BDI-PC was administered to 60 male and 60 female outpatients...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(98)00070-x
更新日期：1999-03-01 00:00:00
