Measuring Behavioral Health Integration in Primary Care
- 1 December 2022
- journal article
- research article
- Published by Mary Ann Liebert Inc in Population Health Management
- Vol. 25 (6), 721-728
- https://doi.org/10.1089/pop.2022.0160
Abstract
Behavioral health integration (BHI) within primary care settings is shown to improve outcomes. However, achieving BHI requires identifying best practices and a reliable tool that can be used to measure existing levels and progress toward BHI. The objective of this study was to develop and apply a conceptual framework to measure BHI, test the approach, and examine challenges to achieving BHI. Surveys and interviews were conducted with key informants within 17 designated public hospitals in California at the midpoint of participating in a 5-year project to establish BHI. A framework and coding methodology were developed to assess BHI best practices at each hospital. BHI status was assessed in the domains of infrastructure and process. Each domain included 5 themes such as electronic health record integration and functionality (infrastructure) and interprovider communication (process). Themes were assessed using a 6-point scale for various activities under a theme and associated weights. Theme-specific values were standardized from 0% to 100% to compare BHI scores between hospitals. Overall progress toward BHI ranged from scores of 52% to 83% (mean 63%) and indicated greater contribution of infrastructure versus process implementation. Within the infrastructure domain, scores were higher for having institutional and provider support, but lagged in establishing provider proximity. Within the process domain, scores were highest for implementation of behavioral health screening, but were frequently lower for other themes such as use of care coordination and referral processes. Further research is needed to test the robustness of this approach in other settings.Keywords
This publication has 28 references indexed in Scilit:
- Integrating Behavioral Health into Primary CarePopulation Health Management, 2016
- Clinician Staffing, Scheduling, and Engagement Strategies Among Primary Care Practices Delivering Integrated CareThe Journal of the American Board of Family Medicine, 2015
- Characteristics of Effective Collaborative Care for Treatment of Depression: A Systematic Review and Meta-Regression of 74 Randomised Controlled TrialsPLOS ONE, 2014
- Impact of Hospital Variables on Case Mix Index as a Marker of Disease SeverityPopulation Health Management, 2014
- A needs-based method for estimating the behavioral health staff needs of community health centersBMC Health Services Research, 2013
- Developing a measure of provider adherence to improve the implementation of behavioral health services in primary care: a Delphi studyImplementation Science, 2013
- Collaborative care for depression and anxiety problemsEmergencias, 2012
- Addressing the Workforce Crisis in Integrated Primary CareJournal of Clinical Psychology in Medical Settings, 2009
- Implications of a Needs-Based Approach to Estimating Psychiatric Workforce RequirementsAcademic Psychiatry, 2003
- Integrated Primary Care: Organizing the Evidence.Families, Systems, & Health, 2003