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Cited by 441Psychiatric care and mental health servicesMental Health Treatment and AccessPrimary Care and Health Outcomes

Integrated Medical Care for Patients With Serious Psychiatric Illness: A Randomized Trial

Druss, Benjamin G., Rohrbaugh, Robert M., Levinson, Carolyn M., Rosenheck, Robert A.·2001·Archives of General Psychiatry
DOI 10.1001/archpsyc.58.9.861
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Abstract

BACKGROUND: This randomized trial evaluated an integrated model of primary medical care for a cohort of patients with serious mental disorders. METHODS: A total of 120 individuals enrolled in a Veterans Affairs (VA) mental health clinic were randomized to receive primary medical care through an integrated care initiative located in the mental health clinic (n = 59) or through the VA general medicine clinic (n = 61). Veterans who obtained care in the integrated care clinic received on-site primary care and case management that emphasized preventive medical care, patient education, and close collaboration with mental health providers to improve access to and continuity of care. Analyses compared health process (use of medical services, quality of care, and satisfaction) and outcomes (health and mental health status and costs) between the groups in the year after randomization. RESULTS: Patients treated in the integrated care clinic were significantly more likely to have made a primary care visit and had a greater mean number of primary care visits than those in the usual care group. They were more likely to have received 15 of the 17 preventive measures outlined in clinical practice guidelines. Patients assigned to the integrated care clinic had a significantly greater improvement in health as measured by the physical component summary score of the 36-Item Short-Form Health Survey than patients assigned to the general medicine clinic (4.7 points vs -0.3 points, P<.001). There were no significant differences between the 2 groups in any of the measures of mental health symptoms or in total health care costs. CONCLUSION: On-site, integrated primary care was associated with improved quality and outcomes of medical care.

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Crossref · 10.1001/archpsyc.58.9.861

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  • Our HRs reflect recent standardised mortality ratio estimates from the UK.

    “In particular, suicide rates were lower than would be expected from Office for National Statistics (ONS) data67 but we would not expect these to be differential by diagnostic group and our HRs reflect recent standardised mortality ratio estimates from the UK.4,68”

    From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [68]

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Authors
Druss, B. G., Rohrbaugh, R. M., Levinson, C. M., & Rosenheck, R. A.
Affiliations
Yale University (US)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2001-09-01
Volume
58
Issue
9
Pages
861
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.58.9.861
OpenAlex
W2144688807
Cited by
441
References
48
Citations by year
2026: 4 · 2025: 3 · 2024: 9 · 2023: 6 · 2022: 9 · 2021: 9 · 2020: 17 · 2019: 18 · 2018: 24 · 2017: 55 · 2016: 17 · 2015: 16 · 2014: 29 · 2013: 29 · 2012: 21
FWCI
11.54
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (7k08mh001556-05)
  • National Institute of Mental Health (K08 MH01556)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
integrated care, primary care, severe mental illness, veterans, case management, preventive medicine, continuity of care, health care access, physical health outcomes, mental health outcomes, health care costs, quality of care, patient satisfaction
MeSH terms
Adult, Mental Disorders, Continuity of Patient Care, Female, Follow-Up Studies, Health Services Research, Health Status Indicators, Humans, Male, Middle Aged, Patient Education as Topic, Preventive Health Services, Primary Health Care, Severity of Illness Index, Cohort Studies, Treatment Outcome, Patient Satisfaction, Outcome Assessment, Health Care, Practice Guidelines as Topic, Delivery of Health Care, Integrated, Quality Indicators, Health Care

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