Utah study: Integrating mental, physical healthcare improves outcomes, lowers costs

Integrating physical and mental healthcare resulted in more treatment and diagnosis of depression, better patient outcome and lower cost to patients, according to researchers at Intermountain Healthcare. Photo by Alexander Raths/Shutterstock

SALT LAKE CITY, Aug. 29 (UPI) — The more information doctors have about their patients, the better the healthcare is, suggesting team-based strategies to get specialists on the same page could lead to healthier people.

Researchers at Intermountain Medical Center in Murray found integrating physical and mental healthcare led to better clinical outcomes, less need for healthcare services and overall lower costs for care, according to a study published in the Journal of the American Medical Association.

A review of patient records for the integrated health system, which has a large network of hospitals, clinics and physicians in Utah, showed screening for depression in more patients resulted in more of them receiving treatment, and appeared to help doctors better care for other conditions such as diabetes and high blood pressure.

“Team-based care is just that, a team of healthcare providers from diverse disciplines — physicians, advanced practice clinicians, nurses, mental health providers, and other staff members — who work together with patients, families and communities to provide coordinated healthcare services,” Dr. Brenda Reiss-Brennan, director of mental health integration at Intermountain, said in a press release. “The team works collaboratively with patients to set and accomplish shared goals for improving patient outcomes.”

For the study, researchers reviewed records for 113,452 patients who received care at one of 27 team-based practices or 75 traditional practices between 2010 and 2013.

Overall, 46.1 percent of patients in team-based practices were diagnosed and treated for active depression, compared to 24.1 percent in traditional practices. Among patients with diabetes, 24.6 percent in the team-based practices followed diabetes care instruction, compared to 19.5 percent in traditional practices and 48.4 percent of patients with a team of doctors had a documented self-care plan, compared to just 8.7 percent at traditional practices.

The result of all this, researchers report, was patients at team-based practices experienced a 23 percent reduction in emergency room visits, a 10.6 percent reduction in hospital admissions, a 7 percent reduction in primary care physician encounters and 3.3 percent lower costs for care.

While the study suggests worse care for patients with high blood pressure — researchers note this was not a primary focus of physicians, compared to attention paid to depression and diabetes — and that the health system received fewer payments for services, the overall benefit to patients seems apparent.

“For patients, the bottom line of the study is that getting care in a team-based setting where medical providers work hand-in-hand with mental health professionals results in higher screening rates, more proactive treatment, and better clinical outcomes for complex chronic disease,” said Reiss-Brennan. “Team-based care means providers work together to care for all chronic conditions, mental and physical. At Intermountain, 80 percent of mental health services are provided by primary care physicians, and when they’re supported by an integrated team, both they and their patients benefit.”


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