1. Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
- Author
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Grove LR, Olesiuk WJ, Ellis AR, Lichstein JC, DuBard CA, Farley JF, Jackson CT, Beadles CA, Morrissey JP, and Domino ME
- Subjects
- Adult, Chronic Disease epidemiology, Comorbidity, Female, Humans, Male, Middle Aged, North Carolina epidemiology, Schizophrenia epidemiology, United States, Chronic Disease therapy, Medicaid statistics & numerical data, Medication Adherence statistics & numerical data, Mental Health Services statistics & numerical data, Patient-Centered Care statistics & numerical data, Primary Health Care statistics & numerical data, Schizophrenia therapy
- Abstract
Objective: Primary care-based medical homes could improve the coordination of mental health care for individuals with schizophrenia and comorbid chronic conditions. The objective of this paper is to examine whether persons with schizophrenia and comorbid chronic conditions engage in primary care regularly, such that primary care settings have the potential to serve as a mental health home., Method: We examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007-2010. Using a fixed-effects regression approach, we also assessed the effect of medical home enrollment on utilization of primary care and specialty mental health care and medication adherence., Results: A substantial majority (78.5%) of person-years had at least one primary care visit, and 17.9% had at least one primary care visit but no specialty mental health services use. Medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence., Conclusions: Medical home enrollees with schizophrenia and comorbid chronic conditions exhibited significant engagement in primary care, suggesting that primary-care-based medical homes could serve a care coordination function for persons with schizophrenia., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
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