2015 APHA Annual Meeting & Expo

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333113
Use of patient-centered medical homes by non-elderly adults with serious mental illness


Tuesday, November 3, 2015

Jennifer Bowdoin, MS, Health Policy and Management, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
Rosa Rodriguez-Monguio, PhD, MS, Health Policy and Management, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Amherst, MA
Elaine Puleo, PhD, University of Massachusetts, School of Public Health and Health Sciences, Amherst, MA
David Keller, MD, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
Joan Roche, PhD, RN GCNS-BC, College of Nursing, University of Massachusetts Amherst, Amherst, MA
Introduction. The poor health and social outcomes of people with serious mental illness are widely recognized as a major public health concern with important social and economic consequences. Prior research indicates that the PCMH model holds promise for improving health care outcomes, while containing the cost of care. However, research on the use of PCMHs by non-elderly adults with serious mental illness is limited. 

Objectives. This study assesses the extent to which non-elderly adults with serious mental illness receive care consistent with the PCMH model compared to non-elderly adults without mental illness and non-elderly adults with mild to moderate mental illness.

Methods. This surveillance study uses self-reported data for a national sample of participants (n=38,570) from the 2007-2012 Medical Expenditure Panel Survey, a set of large-scale surveys that provide nationally representative estimates for a range of socio-economic, demographic, and health care characteristics for the civilian non-institutionalized population in the United States. Due to the lack of a PCMH indicator in the dataset, several proxy variables were tested to assess use of PCMHs by study participants. 

Results. This study found low rates of PCMH use (1%-30%, depending on the PCMH variable being tested) among non-elderly adults with serious mental illness. Most analyses indicated that non-elderly adults without mental illness tend to be more likely to receive care consistent with the PCMH model than non-elderly adults without serious mental illness, but the results were not consistent across the analyses and generally were not statistically significant. 

Conclusion. This study did not find substantial differences in use of PCMHs for non-elderly adults with serious mental illness relative to non-elderly adults without mental illness. Additional research is needed to understand whether there are mental illness-related disparities in the use of PCMHs and to examine the health and economic impact of PCMHs for this population.

Learning Areas:

Chronic disease management and prevention
Provision of health care to the public

Learning Objectives:
Assess the extent to which non-elderly adults with serious mental illness receive care consistent with the patient-centered medical home (PCMH) model of care

Keyword(s): Health Care Delivery, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator on a research study on the use of patient-centered medical homes (PCMH) and the association between the PCMH model and receipt of preventive care, health care quality, utilization, and costs for this population. I also have over ten years of experience related to health care program development and management, including state-level PCMH programs and programs and services for adults with serious mental illness.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4438.0: Medical Care Student Awards Session