Alexander S. Young, Jessica Skela, Evelyn T. Chang, Rebecca Oberman, Prabha Siddarth
Abstract
The population with serious mental illness has high risk for hospitalization or death due to unhealthy behaviors and inadequate medical care, though the level of risk varies substantially. Programs that integrate medical and psychiatric services
Introduction
Healthcare organizations are increasingly responsible for providing comprehensive care of populations of patients, and for improving treatment quality while controlling costs. Serious mental illnesses such as bipolar disorder or schizophrenia are present in a substantial proportion of patients with preventable emergency visits, hospitalizations or death [1,2].
Materials and Methods
The SMI PACT project was registered with ClinicalTrials.gov (identifier NCT01668355) and the research methods and clinical trial results have been published previously [8,11,17]. Service integration occurred at the Veterans Affairs Greater Los Angeles Healthcare System, one of the largest VHA healthcare systems in the United States.
Result
Table 1 describes the sample, including characteristics and in-person assessment measures stratified by CAN risk percentile of 75–85 (n = 89), 85–95 (n = 51) and 95–99 (n = 23). Nearly 80% of patients had some college education, 35% had schizophrenia, 35% had bipolar disorder, and 28% had chronic, severe, disabling Post-Traumatic Stress Disorder.
Discussion
This study suggests that improvements in care and outcomes do not vary significantly by level of health risk. There is improvement in healthcare and outcomes across multiple domains even for those with extremely high risk. However, the magnitude of improvement can vary. With this study’s intervention, there was minimal improvement in patient activation or physical health-related quality of life
Acknowledgments
The contents of this publication and the views expressed herein do not necessarily represent the views of the Department of Veterans Affairs or affiliated institutions.
Citation: Young AS, Skela J, Chang ET, Oberman R, Siddarth P (2024) Variation in benefit among patients with serious mental illness who receive integrated psychiatric and primary care. PLoS ONE 19(5): e0304312. https://doi.org/10.1371/journal.pone.0304312
Editor: Mu-Hong Chen, Taipei Veterans General Hospital, TAIWAN
Received: January 21, 2024; Accepted: May 6, 2024; Published: May 23, 2024.
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Data Availability: "The data used in this study are the property of the United States government Department of Veterans Affairs. Electronic health records contain substantial sensitive information, private information and information that is protected by United States statute and regulation, including HIPAA. Therefore, it is not possible for us to share the data used in these analyses. Data can be requested from the authors or the research service of the Great Los Angeles Veterans Healthcare System, which can be reached at 1-310-268-4437 or [email protected]".
Funding: This research was supported by the U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Quality Enhancement Research Initiative (SDP 12-177; AY), and Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC; AY). https://www.queri.research.va.gov/ Funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0304312#ack
