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To Your Health: NLM update Transcript

Improving care via health integration: 10/17/2016

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health - a consumer health oriented podcast from NLM - that helps you use MedlinePlus to follow up on weekly topics.

The integration of behavioral health with primary care in large medical centers comparatively improves both health outcomes and health care utilization and may be a prudent investment, notes a comprehensive, comparative study recently published in the Journal of the American Medical Association.

In an 11-year study of more than 113,000 adults in 102 primary care centers of Intermountain Healthcare in Salt Lake City, the study's eight authors found a team-based integration of behavioral health with primary care (compared to care without the collaboration) improved patient screening for depression, adherence to several measures of ongoing diabetes care, and self-care planning.

In addition, patients who experienced the team-based integration of behavioral health with primary care comparatively had significant reductions in emergency department visits, fewer hospital and ambulance admissions, as well as decreased primary care physician visits. The study's authors note all the latter reductions curb costs for Intermountain Healthcare (a large, mostly urban/suburban clinical provider) over time.

An editorial that accompanied the study explains (and we quote): 'the overall investment cost of the program was.... just under $10 per patient annually, or about $100 per patient for the 11 year period' (end of quote).

The editorial's author adds (and we quote) 'The total program investment was about $12 million; a seemingly trivial amount for a health system of this size compared with the substantial reductions in resource utilization' (end of quote).

However, the editorial's author acknowledges that Intermountain Healthcare received $157 million less in insurance reimbursement (during the study's 11 year period) for patients who received integrated versus traditional care.

Still, the editorial's author concludes the research (and we quote)' document(s) the value of an integrated model of mental health and chronic disease care that likely can be provided to patients who receive their care in large, integrated health systems' (end of quote).

The editorial's author adds the findings (in conjunction with pending changes in medical insurance reimbursement for integrated care) pave a partial path for improvements in health care delivery.

I hasten to add that Intermountain Healthcare is not the only U.S. clinical center that integrates behavioral health and primary medical care within a broader effort to treat the whole patient. Intermountain Health is just one of the first to comprehensively assess the effort's impact on patients and health care delivery. Let's hope the study's positive findings add to the momentum to provide integrated care services within the nation's medical centers.

Meanwhile, some strategies to find high quality behavioral health care (from the Joint Commission) are available within the 'related issues' section of MedlinePlus.gov's choosing a doctor health topic page. Information to help you select mental health services and providers (from the Mayo Foundation for Medical Education and Research) similarly is available within the 'related issues' section of MedlinePlus.gov's choosing a doctor health topic page.

MedlinePlus.gov's choosing a doctor health topic page also provides a patient handout on selecting a primary care physician, which is available in the 'patients handouts' section. You can sign up to receive updates about choosing a doctor as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's choosing a doctor health topic page, please type 'choosing a doctor' in the search box on MedlinePlus.gov's home page, then, click on 'choosing a doctor (National Library of Medicine).' MedlinePlus.gov also has health topic pages devoted to health facilities and patient safety.

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It was nice to be with you. Please join us here next week and here's to your health!