在精神卫生诊所实施协作式慢性病管理模式：实现和维持临床效果。
Implementing the Collaborative Chronic Care Model in Mental Health Clinics: Achieving and Sustaining Clinical Effects.
机构信息
Center for Healthcare Organization and Implementation Research, and the Behavior Health Quality Enhancement Research Initiative, U.S. Department of Veterans Affairs (VA), Boston (all authors); Department of Psychiatry, Harvard Medical School, Boston (Bauer, Miller, Kim, Connolly); Department of Biostatistics, Boston University School of Medicine, Boston (Lew).
出版信息
Psychiatr Serv. 2021 May 1;72(5):586-589. doi: 10.1176/appi.ps.202000117. Epub 2021 Mar 18.
OBJECTIVE
Collaborative chronic care models (CCMs) were established with implementation support in nine mental health clinics. This study sought to determine whether their clinical impact was maintained after implementation support ceased.
METHODS
Posttrial data were analyzed from a randomized stepped-wedge CCM implementation trial in general mental health clinics in nine Department of Veterans Affairs medical centers. Sites received 1 year of implementation support, which was associated with reduced mental health hospitalization rates compared with non-CCM clinics in the same medical centers. Hospitalization rates for the year after implementation support were analyzed by using repeated measures logistic regression comparing the same clinics.
RESULTS
Hospitalization rates for the postsupport year did not differ from comparison clinics either in the population that initially showed the difference or the population active in the clinics at the end of the year of implementation support.
CONCLUSIONS
Clinical effects of the CCM may wane after cessation of active implementation support.
目的
在 9 家心理健康诊所建立了协作式慢性病管理模式（CCM）并提供实施支持。本研究旨在确定在实施支持停止后，其临床效果是否仍然存在。
方法
对 9 家退伍军人事务部医疗中心的一般心理健康诊所进行的 CCM 实施试验的试验后数据进行了分析。这些地点接受了 1 年的实施支持，与同一医疗中心的非 CCM 诊所相比，心理健康住院率有所降低。通过对相同诊所进行重复测量逻辑回归分析，比较了实施支持年后的住院率。
结果
在最初显示差异的人群或在实施支持年结束时在诊所活跃的人群中，支持年后的住院率与对照诊所没有差异。
结论
在积极实施支持停止后，CCM 的临床效果可能会减弱。
Zotero 插件