Department of Family Medicine, Primary Care Research Institute, The State University of New York at Buffalo, 462 Grider Street, SUNY Clinical Center, Buffalo, NY 14215, USA.
Community Ment Health J. 2013 Apr;49(2):172-7. doi: 10.1007/s10597-012-9521-2. Epub 2012 Jul 24.
Individuals with severe mental health disorders experience difficulty maneuvering the complexity encountered in primary care (PC). This study describes the impact of three components of primary care practice enhancements on: changes in missed appointments, changes in health outcomes, number of ER visits and hospitalization days, and perceptions of integrated care. Missed PC appointments: baseline to post practice enhancement changed from 42 to 11, statistically significant (p < .01). Changes in health outcomes: SF-12 scores had no significant change nor did ER utilization and hospitalization; however, outcomes are low-base rate and assessment period was short. Integration of care: liaison was most helpful in accessing and navigating PC, educating and reconciling medication lists. Behavioral health staff voiced relief regarding access and felt better informed. Strategies focusing on increasing communication, staff education, and reducing barriers to access and receipt of PC may improve integration and continuity of care.
患有严重精神健康障碍的个体在处理初级保健（PC）中遇到的复杂性方面存在困难。本研究描述了增强初级保健实践的三个组成部分对以下方面的影响：错过预约的变化、健康结果的变化、急诊就诊次数和住院天数以及对综合护理的看法。错过 PC 预约：从基线到实践增强后的变化从 42 次变为 11 次，具有统计学意义（p<0.01）。健康结果的变化：SF-12 评分没有显著变化，急诊就诊和住院也没有变化；然而，结果的基础率较低，评估期较短。护理的整合：联络员在获取和导航 PC、教育和协调药物清单方面最有帮助。行为健康工作人员对获得途径表示宽慰，并感到获得的信息更多。专注于增加沟通、员工教育以及减少获取和接受 PC 的障碍的策略可能会改善整合和护理的连续性。
