Behavioral health in the Department of Defense Patient-Centered Medical Home: history, finance, policy, work force development, and evaluation
Tóm tắt
Integrating behavioral health services into the patient-centered medical home (PCMH) is an important component for meeting the goals of easy access, whole person, coordinated, and integrated care. Unlike most PCMH initiatives, the Department of Defense’s (DoD) Military Health System (MHS) launched its PCMH initiative with integrated behavioral health services. This integration facilitates the MHS’s goal to meet its strategic imperatives under the “Quadruple Aim” of (1) maximizing readiness, (2) improving the health of the population, (3) enhancing the patient experience of care (including quality, access, and reliability), and (4) responsibly managing per capita cost of care. The MHS experience serves as a guide to other organizations. We discuss the historical underpinnings, funding, policy, and work force development strategies that contributed to integrated behavioral healthcare being a mandated component of the MHS’s PCMH.
Tài liệu tham khảo
NCQA’s Patient-Centered Medical Home (PCMH) 2011. Retrieved from the PCMH 2011 Overview link on February 29, 2012 from http://www.ncqa.org/tabid/1472/Default.aspx.
Runyan CN, Vincent VP, Meyer JG, et al. A novel approach for mental health disease management: The Air Force medical service’s interdisciplinary model. Dis Manag. 2003;6:179-188.
Harris DM, LeFavour J. Final evaluation of Navy’s medicine’s behavioral health integration program (BHIP) two-year demonstration project. The CNA Corporation; 2005.
Oxman TE, Dietrich AJ, Williams JW Jr, Kroenke K. A three-component model for reengineering systems for the treatment of depression in primary care. Psychosomatics. 2002;43(6):441-450.
Dietrich AJ, Oxman TE, Williams JW Jr, et al. Re-engineering systems for the treatment of depression in primary care: cluster randomized controlled trial. BMJ. 2004;7466(329):602.
Zatzick D, Roy-Byrne P, Russo J, Rivara F, et al. A randomized effectiveness trial of stepped collaborative care for acutely injured trauma survivors. Arch Gen Psychiatry. 2004;61(5):498-506.
Engel CC, Oxman T, Yamamoto C, et al. RESPECT-Mil: feasibility of a systems-level collaborative care approach to depression and post-traumatic stress disorder in military primary care. Mil Med. 2008;173:935-940.
Engel CC, Weil J, Curry J et al. Disseminating effective integrated mental health and primary care services for PTSD and depression in the U.S. military. Paper presentation for the American Psychiatric Association presidential symposium 3: New approaches to integration of mental health and medical health services; Katon WJ, Unützer J, Zatzick D, Druss B, Engel CC. 165th Annual Meeting of the American Psychiatric Association. Philadelphia, PA, May 7, 2012.
Department of Defense Task Force on Mental Health. An achievable vision: Report of the Department of Defense Task Force on Mental Health. Falls Church: Defense Health Board; 2007.
Department of Defense. Quadrennial defense review report; 2010.
Hunter CL, Goodie JL, Oordt MS, et al. Integrated behavioral health in primary care; step-by-step guidance for assessment and intervention. Washington: American Psychological Association; 2009.
Robinson PJ, Reiter JT. Behavioral consultation and primary care: a guide to integrating services. New York: Springer; 2007.
Hunter CL, Goodie JL. Operational and clinical components for integrated-collaborative behavioral healthcare in the patient-centered medical home. Fam Syst Health. 2010;28:308-321.
Primary behavioral health care services practice manual: version 2.0. San Antonio, TX: United States Air Force; 2011.
Navy medicine primary behavioral health care services behavioral health integration program: practice manual for the demonstration project: version 3.0. Washington, DC: United States Navy; 2003.
RESPECT-MIL care facilitator reference manual: three component model for primary care management of depression and PTSD (Military version). Uniformed Services University; 2008.
Meyers D, Peikes D, Dale S, et al. Improving evaluation of the Medical Home. AHRQ Publication No. 11-0091. Rockville: Agency for Healthcare Research and Quality; 2011.