title: Family practice enhancements for patients with severe mental illness.
abstract: Individuals with severe mental health disorders experience difficulty maneuvering the complexity encountered in primary care (PC). This study describes the impact of three components of primary care practice enhancements on: changes in missed appointments, changes in health outcomes, number of ER visits and hospitalization days, and perceptions of integrated care. Missed PC appointments: baseline to post practice enhancement changed from 42 to 11, statistically significant (p < .01). Changes in health outcomes: SF-12 scores had no significant change nor did ER utilization and hospitalization; however, outcomes are low-base rate and assessment period was short. Integration of care: liaison was most helpful in accessing and navigating PC, educating and reconciling medication lists. Behavioral health staff voiced relief regarding access and felt better informed. Strategies focusing on increasing communication, staff education, and reducing barriers to access and receipt of PC may improve integration and continuity of care.
authors: Department of Family Medicine, Primary Care Research Institute, The State University of New York at Buffalo, 462 Grider Street, SUNY Clinical Center, Buffalo, NY 14215, USA. patricia.pastore6@gmail.com
authors: Patricia
authors: P
authors: Pastore
authors: Kim S
authors: KS
authors: Griswold
authors: Gregory G
authors: GG
authors: Homish
authors: Robert
authors: R
authors: Watkins
mesh_terms: D000328:Adult; D000368:Aged; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009518:New York; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research; D012720:Severity of Illness Index