Bridges Ana J, Villalobos Bianca T, Anastasia Elizabeth A, Dueweke Aubrey R, Gregus Samantha J, Cavell Timothy A
Department of Psychological Science, University of Arkansas.
Fam Syst Health. 2017 Jun;35(2):193-206. doi: 10.1037/fsh0000268.
This paper is a report on a study exploring a potential typology of primary care patients referred for integrated behavioral health care (IBHC) services. We considered whether primary care patients could be grouped into meaningful clusters based on perceived need for behavioral health services, barriers to accessing care, and past-year service utilization. We also described the development of a working partnership between our university-based research team and a federally qualified health center (FQHC).
A total of 105 adult primary care patients referred for same-day behavioral health appointments completed a brief self-report questionnaire assessing past-year behavioral health concerns, service utilization, and perceived barriers to utilization.
Hierarchical and k-means cluster analyses revealed 3 groups: (a) Well-Served patients, characterized by high perceived need for services, high service use, and low barriers to service use (40%); (b) Underserved patients, characterized by high perceived need, low service utilization, and high barriers to service use (20%); and (c) Subclinical patients, characterized by low perceived need, low service use, and low barriers to service use (20%). Clusters were reliably differentiated by age, primary language, insurance status, and global functioning.
We found primary care patients could be grouped into 3 categories and that 60% (Underserved and Subclinical) represented groups less commonly seen in traditional mental health (MH) settings. IBHC may be a promising approach for extending the reach of MH care, and partnerships between FQHCs and university-based research teams may be a promising approach for conducting research on the IBHC service-delivery model. (PsycINFO Database Record
本文是一项关于探索转诊接受综合行为健康护理（IBHC）服务的初级保健患者潜在类型学的研究报告。我们考虑了初级保健患者是否可以根据对行为健康服务的感知需求、获得护理的障碍以及过去一年的服务利用情况分为有意义的类别。我们还描述了我们以大学为基础的研究团队与一家联邦合格健康中心（FQHC）之间建立工作伙伴关系的过程。
共有105名转诊接受当日行为健康预约的成年初级保健患者完成了一份简短的自我报告问卷，评估过去一年的行为健康问题、服务利用情况以及感知到的利用障碍。
层次聚类分析和k均值聚类分析揭示了3组：（a）得到充分服务的患者，其特征是对服务的感知需求高、服务使用高且服务使用障碍低（40%）；（b）服务不足的患者，其特征是感知需求高、服务利用率低且服务使用障碍高（20%）；（c）亚临床患者，其特征是感知需求低、服务使用低且服务使用障碍低（20%）。各聚类在年龄、主要语言、保险状况和整体功能方面有可靠的差异。
我们发现初级保健患者可以分为3类，其中60%（服务不足和亚临床）代表在传统心理健康（MH）环境中较少见到的类别。IBHC可能是扩大MH护理覆盖范围的一种有前景的方法，FQHC与以大学为基础的研究团队之间的伙伴关系可能是对IBHC服务提供模式进行研究的一种有前景的方法。（PsycINFO数据库记录
