Community Mental Health Center Integrated Care Outcomes
Despite the compelling logic for integrating care for people with serious mental illness, there is also need for quantitative evidence of results. This retrospective analysis used 2013–2015 data from seven community mental health centers to measure clinical processes and health outcomes for patients receiving integrated primary care (n = 18,505), as well as hospital use for the 3943 patients with hospitalizations during the study period. Bivariate and regression analyses tested associations between integrated care and preventive screening rates, hemoglobin A1c levels, and hospital use. Screening rates for body-mass index, blood pressure, smoking, and hemoglobin A1c all increased very substantially during integrated care. More than half of patients with baseline hypertension had this controlled within 90 days of beginning integrated care. Among patients hospitalized at any point during the study period, the probability of hospitalization in the first year of integrated care decreased by 18 percentage points, after controlling for other factors such as patient severity, insurance status, and demographics (p < .001). The average length of stay was also 32% shorter compared to the year prior to integrated care (p < .001). Savings due to reduced hospitalization frequency alone exceeded $1000 per patient. Data limitations restricted this study to a pre−/post-study design. However, the magnitude and consistency of findings across different outcomes suggest that for people with serious mental illness, integrated care can make a significant difference in rates of preventive care, health, and cost-related outcomes.
KeywordsIntegration Community mental health center Primary care Preventive screening Hypertension Hospital use
This study was funded by the Meadows Mental Health Policy Institute, the Texas Health and Human Services Commission, and the Centers for Medicare and Medicaid Services (#11-W-00278/6). The findings are those of the authors and do not necessarily represent the official position of the funders.
Compliance with Ethical Standards
Conflict of Interest
Rebecca Wells declares that she has no conflict of interest.
Bobbie Kite declares that she has no conflict of interest.
Ellen Breckenridge declares that she has no conflict of interest.
Tenaya Sunbury declares that she has no conflict of interest.
All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Because the data in this study derived from agency records, the principal investigator’s IRB waived informed consent as infeasible to obtain. Analyses were conducted only on de-identified data.
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