Colorado Community Managed Care Network, Denver, CO USA ; Department of Family Medicine, University of Colorado Denver, Denver, CO USA.
Transl Behav Med. 2012 Sep;2(3):337-44. doi: 10.1007/s13142-012-0141-8.
Although the benefits of integrating behavioral health (BH) services into primary care are well established (World Health Organization and World Organization of Family Doctors, 2012; Chiles et al. in Clin Psychol-Sci Pr 6:204-220, 1999; Cummings 1997; O'Donohue et al. 2003; Olfson et al. in Health Aff 18:79-93, 1999; Katon et al. in Ann Intern Med 124:917-925, 2001; Simon et al. in Arch Gen Psychiatry 52:850-856, 1995; Anderson et al. in Diabetes Care 24:1069-1078, 2001; Ciechanowski et al. in Arch Intern Med 160:3278-3285, 2000; Egede et al. in Diabetes Care 25:464-470, 2002), research has focused primarily on describing the types of interventions behavioral health providers (BHPs) employ rather than on reasons for referral, treatment initiation rates, or the patient characteristics that may impact them. This study presents the results of a multisite card study organized by The Collaborative Care Research Network, a subnetwork of the American Academy of Family Physicians' National Research Network devoted to conducting practice-based research focused on the provision of BH and health behavior services within primary care practices. The goals of the study included: (1) identifying the characteristics of patients referred for BH services; (2) codifying reasons for referral and whether patients were treated for the referral; (3) exploring any differences between patients who initiated BH contact and those who did not; and (4) assessing the types and frequency of BH services provided to patients who attended at least one appointment. Of the 200 patients referred to a BHP, 81 % had an initial contact, 71 % of which occurred on the same day. Men and women were equally likely to engage with a BHP although the time between appointments varied by gender. Depression and anxiety were the primary reasons for referral. Practice-based research is a viable strategy for advancing the knowledge about integrated primary care.
尽管将行为健康 (BH) 服务整合到初级保健中的益处已得到充分证实（世界卫生组织和世界家庭医生组织，2012 年；Chiles 等人，Clin Psychol-Sci Pr 6:204-220, 1999 年；Cummings 1997 年；O'Donohue 等人，2003 年；Olfson 等人，Health Aff 18:79-93, 1999 年；Katon 等人，Ann Intern Med 124:917-925, 2001 年；Simon 等人，Arch Gen Psychiatry 52:850-856, 1995 年；Anderson 等人，Diabetes Care 24:1069-1078, 2001 年；Ciechanowski 等人，Arch Intern Med 160:3278-3285, 2000 年；Egede 等人，Diabetes Care 25:464-470, 2002 年），但研究主要集中在描述行为健康提供者 (BHPs) 采用的干预类型上，而不是转诊的原因、治疗开始率或可能影响治疗的患者特征。本研究介绍了由协作护理研究网络组织的多地点卡片研究的结果，该网络是美国家庭医生学会国家研究网络的一个子网，致力于开展以提供初级保健中的 BH 和健康行为服务为重点的基于实践的研究。该研究的目标包括：(1) 确定转介 BH 服务的患者特征；(2) 对转诊原因进行编码，以及患者是否因转诊接受治疗；(3) 探索开始 BH 接触和未开始 BH 接触的患者之间的任何差异；(4) 评估至少接受一次预约的患者接受的 BH 服务的类型和频率。在转介给 BHP 的 200 名患者中，81%的患者进行了首次接触，其中 71%的接触发生在同一天。男性和女性接受 BHP 治疗的可能性相同，尽管预约之间的时间因性别而异。抑郁和焦虑是转诊的主要原因。基于实践的研究是推进综合初级保健知识的可行策略。
