Abstract
BackgroundPrimary care practices are changing the way that they provide care by increasing their medical home functionality. Medical home functionality can improve access to care and increase patient-centeredness, which is essential for persons with mental health issues. This study aims to explore the degree to which medical home functions have been implemented by primary care practices that care for adults with psychological distress.MethodsAnalysis of the 2015 Medical Expenditure Panel Survey Household Component and Medical Organizations Survey. This unique data set links data from a nationally representative sample of US households to the practices in which they receive primary care. This study focused on adults aged 18 and above.ResultsAs compared to adults without psychological distress, adults with psychological distress had significantly higher rates of chronic illness and poverty. Adults with psychological distress were more likely to receive care from practices that include advanced practitioners and are non-profit or hospital-based. Multivariate models that were adjusted for patient-level and practice-level characteristics indicated that adults with psychological distress are as likely to receive primary care from practices with medical home functionality, including case management, electronic health records, flexible scheduling, and PCMH certification, as adults without psychological distress.ConclusionsPractices that care for adults with mental health issues have not been left behind in the transition towards medical home models of primary care. Policy makers should continue to prioritize adults with mental health issues to receive primary care through this model of delivery due to this population’s great potential to benefit from improved access and care coordination.Trial registrationThis study does not report the results of a health care intervention on human subject’s participants.
Highlights
Primary care practices are changing the way that they provide care by increasing their medical home functionality
A significantly greater percentage of participants with psychological distress (PD) received their primary care from nonprofit or hospital-owned practices (46% vs. 34%), while a significantly smaller percentage received their care from physician-owned primary care practices (45% vs. 59%)
There were no statistical differences between the percentage of participants with and without PD that receive their primary care from practices that have multiple locations
Summary
Primary care practices are changing the way that they provide care by increasing their medical home functionality. This study aims to explore the degree to which medical home functions have been implemented by primary care practices that care for adults with psychological distress. Adults with poor mental health or psychological distress (PD) have complex primary care needs. Primary care physicians are often the only mental health providers for adults with common mental health conditions, like anxiety and depression [1, 2] For these patients, primary care physicians are responsible for diagnosing and managing both physical and mental health conditions. Adults with PD have complex care coordination needs; they may receive various services from community mental health clinics and substance abuse treatment programs, which have long been siloed from medical care providers [10].
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