Abstract:
BACKGROUND:Although many studies have documented patient-, clinician-, and organizational barriers/facilitators of primary care among people with mental illnesses, few have examined whether these factors predict actual rates of preventive service use. We assessed whether clinician behaviors, beliefs, characteristics, and clinician-reported organizational characteristics, predicted delivery of preventive services in this population. METHODS:Primary care clinicians (n = 247) at Kaiser Permanente Northwest (KPNW) or community health centers and safety-net clinics (CHCs), in six states, completed clinician surveys in 2014. Using electronic health record data, we calculated preventive care-gap rates for patients with mental illnesses empaneled to survey respondents (n = 37,251). Using separate multi-level regression models for each setting, we tested whether survey responses predicted preventive service care-gap rates. RESULTS:After controlling for patient-level characteristics, patients of clinicians who reported a greater likelihood of providing preventive care to psychiatrically asymptomatic patients experienced lower care-gap rates (KPNW γ= - .05, p = .041; CHCs γ= - .05, p = .033). In KPNW, patients of female clinicians had fewer care gaps than patients of male clinicians (γ= - .07, p = .011). In CHCs, patients of clinicians who had practiced longer had fewer care gaps (γ= - .004, p = .010), as did patients whose clinicians believed that organizational quality goals facilitate preventive service provision (γ= - .06, p = .006). Case manager availability in CHCs was associated with higher care-gap rates (γ=.06, p = .028). CONCLUSIONS:Clinicians who report they are likely to address preventive concerns when their mentally ill patients present without apparent psychiatric symptoms had patients with fewer care gaps. In CHCs, care quality goals may facilitate preventive care whereas case managers may not.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Yarborough BJH,Stumbo SP,Perrin NA,Hanson GC,Muench J,Green CAdoi
10.1186/s12875-017-0693-2subject
Has Abstractpub_date
2018-01-12 00:00:00pages
16issue
1issn
1471-2296pii
10.1186/s12875-017-0693-2journal_volume
19pub_type
杂志文章abstract:BACKGROUND:Despite increased investment in primary care research and development (R&D), the level of engagement of primary healthcare professionals with research remains poor. The aim of this study is to assess the level of research activity and capacity for research among primary healthcare professionals in a health a...
journal_title:BMC family practice
pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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