Caring for the Whole Person

Caring for the Whole Person: A Patient-Centered Assessment of Integrated Care Models in Vulnerable Populations

The goal of this study is to identify outcomes associated with Behavioral Health Integration (BHI) that matter to patients, to compare changes in outcome over time to measure the impact of different BHI models on different patients, and to create and maintain an Integration Learning Collaborative.

Study Overview

• Status: Unknown
• Conditions: Behavioral Health
• Intervention / Treatment: Other: Access to Care; Other: Depression Screening; Other: Patient-Provider Relationship; Other: Patient-Clinic Interactions; Other: Stigma; Other: Provider Continuity; Other: Symptom Severity; Other: Diagnoses; Other: Social support; Other: Preventive Screening; Other: Inpatient Hospitalization Utilization; Other: Inpatient Readmissions; Other: Post-Admission follow-up

Detailed Description

Twelve safety net clinics have been selected to be a part of this study. The clinics vary on a BHI continuum level, which includes minimal collaboration, basic collaboration at a distance, basic collaboration on site, close collaboration (partially integrated) and close collaboration (fully integrated).

Twelve-thousand patients will be randomly selected from the 12 clinics to be invited to participate in the study. Patients who elect to participate will complete a survey at baseline to collect patient-reported outcomes and again twelve months later.

The Oregon All Providers All Claims (APAC) database will be accessed to analyze financial data regarding the patients at baseline and 12 months.

The hypothesis is that the degree of clinic BHI will predict patient outcomes.

• Study Type: Observational
• Enrollment (Anticipated): 6000

Contacts and Locations

Study Locations

• United States
  • Oregon
    • Portland, Oregon, United States, 97213
      • Center for Outcomes Research and Education, Providence Health & Services

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Patients accessing care at safety net clinic in Oregon.

Description

Inclusion Criteria:

• Age >= 18
• Received care at a safety net care clinic in Oregon

Exclusion Criteria:

-

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Safety Net Clinic Patients; A Cohort of patients in 12 different primary care clinics will be studied to measure how changes in different integration factors impacts the following patient reported outcomes at baseline and 12 months: Access to Care, Patient-Provider Relationship, Patient-Clinic Interactions, Stigma, Provider Continuity, Symptom Severity, Diagnoses, and Social Support. Health care claims data will be accessed to analyze Depression Screening, Preventive Screening, Inpatient Hospitalization Utilization, Inpatient Readmissions, and Post-Admission follow-up at baseline and 12 months.

Other: Access to Care; Patient reported outcome survey administered at baseline and 12 months to measure satisfaction with access to care.; Other: Depression Screening; Analysis of health care claims data for depression screenings at baseline and 12 months.; Other: Patient-Provider Relationship; Patient reported outcome survey administered at baseline and 12 months to measure satisfaction with patient-provider relationship.; Other: Patient-Clinic Interactions; Patient reported outcome survey administered at baseline and 12 months to measure satisfaction with patient-clinic interactions.; Other: Stigma; Patient reported outcome survey administered at baseline and 12 months to measure perceived stigma.; Other: Provider Continuity; Patient reported outcome survey administered at baseline and 12 months to measure satisfaction with provider continuity.; Other: Symptom Severity; Patient reported outcome survey administered at baseline and 12 months to measure symptom severity.; Other: Diagnoses; Patient reported outcome survey administered at baseline and 12 months to measure diagnoses.; Other: Social support; Patient reported outcome survey administered at baseline and 12 months to assess social support and outlets.; Other: Preventive Screening; Analysis of health care claims data for preventive screenings at baseline and 12 months.; Other: Inpatient Hospitalization Utilization; Analysis of health care claims data for Inpatient Hospitalization Utilization at baseline and 12 months.; Other: Inpatient Readmissions; Analysis of health care claims data for Inpatient Hospitalization Readmissions at baseline and 12 months.; Other: Post-Admission follow-up; Analysis of health care claims data for Post-Admission follow-up at baseline and 12 months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in patient reported outcomes	Change in patient reported outcomes at baseline and 12 months	12 months
Change in health care claims	change in health care claims at baseline and 12 months	12 months

Collaborators and Investigators

• Sponsor: Providence Health & Services
• Collaborators: Patient-Centered Outcomes Research Institute; Oregon Health and Science University; Cascadia Addiction Research and Education, LLC; Umpqua Community Health Center; Mosaic Medical; North Portland Clinic; Providence Medical Group; Rockwood Clinic; The Bend Clinic; Yamhill CCO; The Annex; Cascadia Gardiner Clinic; Umpqua Expanded Care Clinic; Bridges Clinic
• Investigators: Principal Investigator: Bill J. Wright, PhD, Director, Center for Outcomes Evaluate and Education, Providence Health & Services

Publications and helpful links

Helpful Links

• Center for Outcomes Research and Education, Providence Health & Services

Study record dates

Study Major Dates

• Study Start: March 1, 2015
• Primary Completion (Anticipated): December 1, 2017
• Study Completion (Anticipated): December 1, 2017

Study Registration Dates

• First Submitted: January 25, 2017
• First Submitted That Met QC Criteria: January 25, 2017
• First Posted (Estimate): January 27, 2017

Study Record Updates

• Last Update Posted (Actual): June 15, 2017
• Last Update Submitted That Met QC Criteria: June 13, 2017
• Last Verified: June 1, 2017

More Information

Terms related to this study

• Keywords: Primary Care; Behavioral Health; Medical Home; Accountable Care Organization; Integration; Health Care Reform
• Other Study ID Numbers: 14-247A

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO