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Behavioral Health Integration and Outcomes that Matter to Patients: a Longitudinal Mixed-Methods Observational Study

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Abstract

Research on behavioral health integration (BHI) often explores outcomes for quality and cost, but less is known about impacts of integration work on key patient experience outcomes. A mixed-methods longitudinal study of BHI was conducted in 12 primary care clinics in Oregon to assess how adoption of key integration practices including integrated staffing models, integrated care trainings for providers, and integrated data sharing impacted a set of patient experience outcomes selected and prioritized by an advisory panel of active patients. Results showed that adopting key aspects of integration was not associated with improved patient experience outcomes over time. Patient interviews highlighted several potential reasons why, including an overemphasis by health systems on the structural aspects of integration versus the experiential components and potential concerns among patients about stigma and discrimination in the primary care settings where integration is focused.

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Funding

This study was funded by the Patient-Centered Outcomes Research Institute (PCORI), Grant #IHS-1310-08388.

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Authors and Affiliations

  1. Center for Outcomes Research and Education, Providence Health & Services, 5251 NE Glisan St, Portland, OR, 97213, USA

    Bill Wright PhD, Kayla Albrecht McMenamin MPH, Kyle Jones MS, MA, Maggie Weller MS, Kristin Brown MA & Natalie Royal Kenton MS, MPH

  2. Ro, New York, USA

    Lauren Broffman PhD, MA

  3. OHSU-PSU School of Public Health, 506 SW Mill St, Portland, OR, 97201, USA

    Laura Jacobson MPH & Nicole Bouranis MA

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  1. Bill Wright PhD
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  2. Lauren Broffman PhD, MA
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All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Natalie Royal Kenton MS, MPH.

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Appendix

Appendix

Table 5 Brief narrative description of study clinics
Full size table
Table 6 Associations between domain-specific integration scores and patient experience outcomes over time
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Wright, B., Broffman, L., McMenamin, K.A. et al. Behavioral Health Integration and Outcomes that Matter to Patients: a Longitudinal Mixed-Methods Observational Study. J Behav Health Serv Res 47, 509–525 (2020). https://doi.org/10.1007/s11414-020-09691-8

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  • DOI: https://doi.org/10.1007/s11414-020-09691-8

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