Department of Health Policy and Management (Presskreischer, Kennedy-Hendricks, McGinty), and Department of Mental Health (Bandara), Johns Hopkins Bloomberg School of Public Health, Baltimore; McLean Hospital, Belmont, Massachusetts, and Department of Healthcare Policy, Harvard Medical School, Boston (Busch); Division of General Internal Medicine and Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Daumit).
Psychiatr Serv. 2021 Nov 1;72(11):1337-1340. doi: 10.1176/appi.ps.202000658. Epub 2021 May 21.
This study examined the association between enrollment in Maryland's behavioral health home (BHH) program and use of outpatient mental health services among people with serious mental illness.
The study sample, drawn from Maryland Medicaid administrative claims data from 2012 through 2017, included 12,232 individuals ages 21-64 with a serious mental illness who were enrolled in a BHH (N=3,319) or never enrolled (N=8,913). A marginal structural modeling approach with inverse probability of treatment weighting was used to examine the association between BHH enrollment and outpatient mental health utilization, measured as the number of visits per 3-month period.
BHH enrollment was associated with 0.8 additional outpatient mental health visits per 3-month period, or approximately three additional visits annually.
A specialty mental health system-based health home model with a primary goal of improving access to general medical care was associated with increased use of outpatient mental health services.
本研究旨在探讨马里兰州行为健康之家（BHH）项目的参与情况与严重精神疾病患者门诊心理健康服务使用之间的关联。
本研究样本来自马里兰州医疗补助管理索赔数据，涵盖了 2012 年至 2017 年间的 12232 名 21-64 岁患有严重精神疾病的个体，其中 3319 名个体参加了 BHH，8913 名个体从未参加过 BHH。采用逆概率治疗加权的边缘结构模型方法来检验 BHH 参与与门诊心理健康利用之间的关联，衡量标准为每 3 个月期间的就诊次数。
BHH 的参与与每 3 个月增加 0.8 次门诊心理健康就诊次数相关，即每年大约增加三次就诊。
以改善一般医疗保健获取为主要目标的专业精神卫生系统为基础的健康之家模式与增加门诊心理健康服务的使用相关。
