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初级保健行为健康中医疗服务提供者行为的叙述性综述:过程数据如何为质量改进提供信息。

Narrative review of provider behavior in primary care behavioral health: How process data can inform quality improvement.

作者信息

Beehler Gregory P, Lilienthal Kaitlin R, Possemato Kyle, Johnson Emily M, King Paul R, Shepardson Robyn L, Vair Christina L, Reyner Jacqueline, Funderburk Jennifer S, Maisto Stephen A, Wray Laura O

机构信息

Center for Integrated Healthcare, VA Western New York Healthcare System.

Gannett Health Services, Cornell University.

出版信息

Fam Syst Health. 2017 Sep;35(3):257-270. doi: 10.1037/fsh0000263. Epub 2017 May 4.

Abstract

OBJECTIVE

Primary care behavioral health (PCBH) is a population-based approach to delivering mental and behavioral health care in the primary care setting. Implementation of the PCBH model varies across practice settings, which can impact how PCBH providers deliver services to patients and in turn may predict a variety of important outcomes. This article aims to characterize PCBH provider engagement in key processes of integrated care as demonstrated in results from empirical studies of real-world clinical practice.

METHOD

For this narrative review of published studies on PCBH provider engagement in processes of care, PubMed and PsycINFO databases were searched from January 1990 through May 2016 to identify relevant articles.

RESULTS

Provider adherence to the brief, time-limited treatment model appears suboptimal. Common mental health conditions, such as depression, were often the primary focus of provider attention, with less consistent emphasis on behavioral medicine concerns. Whereas providers regularly conducted qualitative functional assessments with patients, routine use of standardized measures was low. Engagement in interprofessional collaboration with the primary care team was also low, but engagement in behaviors that fostered therapeutic relationships was high.

DISCUSSION

This review identified several strengths and weaknesses of typical PCBH provider practices. Results are discussed in relation to their value as areas for future quality improvement initiatives that can improve PCBH service delivery and, ultimately, patient outcomes. (PsycINFO Database Record

摘要

目的

基层医疗行为健康(PCBH)是一种在基层医疗环境中提供精神和行为健康护理的基于人群的方法。PCBH模式在不同的实践环境中的实施情况各不相同,这可能会影响PCBH提供者为患者提供服务的方式,进而可能预测各种重要结果。本文旨在通过对实际临床实践的实证研究结果,描述PCBH提供者在综合护理关键过程中的参与情况。

方法

为了对已发表的关于PCBH提供者在护理过程中参与情况的研究进行叙述性综述,我们检索了1990年1月至2016年5月期间的PubMed和PsycINFO数据库,以识别相关文章。

结果

提供者对简短、有时限的治疗模式的依从性似乎不理想。常见的心理健康状况,如抑郁症,往往是提供者关注的主要焦点,而对行为医学问题的关注则不太一致。虽然提供者经常对患者进行定性功能评估,但标准化测量的常规使用率较低。与基层医疗团队进行跨专业协作的参与度也较低,但促进治疗关系的行为参与度较高。

讨论

本综述确定了典型PCBH提供者实践的几个优点和缺点。讨论了这些结果与它们作为未来质量改进举措领域的价值之间的关系,这些举措可以改善PCBH服务的提供,并最终改善患者的治疗结果。(PsycINFO数据库记录)

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