Quality of Mental Health Care at a Student-Run Clinic: Care for the Uninsured Exceeds that of Publicly and Privately Insured Populations.

Diagnosing and treating depression in a primary care practice is an important, yet difficult task, especially for safety-net practices serving the uninsured. In the United States healthcare system, there is a mismatch between the need for mental health care and access to services. This disparity is...

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Publicado en:Journal of Community Health Vol. 36; no. 5; pp. 733 - 741
Autores principales: Liberman, Kate M., Meah, Yasmin S., Chow, Andrew, Tornheim, Jeffrey, Rolon, Omayra, Thomas, David C.
Formato: Artículo
Publicado: Springer Nature Oct2011
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2011
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      pub: Springer Nature
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        10.1007/s10900-011-9367-5
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        atl: Quality of Mental Health Care at a Student-Run Clinic: Care for the Uninsured Exceeds that of Publicly and Privately Insured Populations.
      aug:
        au:
          Liberman, Kate M.
          Meah, Yasmin S.
          Chow, Andrew
          Tornheim, Jeffrey
          Rolon, Omayra
          Thomas, David C.
        affil:
          Mount Sinai School of Medicine, Center for Advanced Medicine, One Gustave Levy Place New York 10029 USA
          Yale-New Haven Hospital Internal Medicine/Pediatrics Department, 20 York Street New Haven 06510 USA
      su:
        New York (State)
        Outpatient medical care
        Analysis of variance
        Mental depression
        Health insurance
        Medical quality control
        Psychiatric treatment
        Antidepressants
        Chi-squared test
        Medical referrals
        Medically uninsured persons
        Probability theory
        Research funding
        Statistics
        Data analysis
        Data analysis software
      sug:
        subj:
          Outpatient medical care
          Analysis of variance
          Mental depression
          Health insurance
          Medical quality control
          Psychiatric treatment
          New York (State)
          Community health centres
          All other out-patient care centres
          All Other Outpatient Care Centers
          Medicinal and Botanical Manufacturing
          Pharmaceutical and medicine manufacturing
          Direct group life, health and medical insurance carriers
          Direct individual life, health and medical insurance carriers
          Antidepressants
          Chi-squared test
          Medical referrals
          Medically uninsured persons
          Probability theory
          Research funding
          Statistics
          Data analysis
          Data analysis software
      keyword:
        Depression
        East Harlem Health Outreach Partnership
        EHHOP
        Immigrant
        Medical students
        Mental health care
        Quality of care
        Student run free clinic
        Uninsured
        Depression
        East Harlem Health Outreach Partnership
        EHHOP
        Immigrant
        Medical students
        Mental health care
        Quality of care
        Student run free clinic
        Uninsured
      ab: Diagnosing and treating depression in a primary care practice is an important, yet difficult task, especially for safety-net practices serving the uninsured. In the United States healthcare system, there is a mismatch between the need for mental health care and access to services. This disparity is most striking among the uninsured. Mental health disorders are more prevalent among the uninsured, and even when diagnosed with mental illness, they are less likely to obtain necessary treatment than insured patients. Given the increasing burden of depression on society, growing numbers of uninsured and negative repercussions of untreated mental illness, improvements in screening and management protocols are becoming more important in primary care practices serving this population. The quality of depression treatment at commercial and public insurance plans in New York City (NYC) and New York State (NYS) were compared to that of the East Harlem Health Outreach Partnership (EHHOP), the student-run clinic of the Mount Sinai School of Medicine. Based on the comparison, the study made recommendations for an integrated, on-site mental health service program at the community health clinic. A cohort of 49 depressed patients were evaluated and treated at the EHHOP clinic. The quality of the mental health care was evaluated according to variables from the Healthcare Effectiveness Data and Information Set (HEDIS). Indicators of quality included demographics, method of diagnosis, type of pharmacological treatment, referral to specialty care, patient adherence to follow-up care and adherence to pharmacologic treatment. When compared to insured patients in NYS, more EHHOP patients had the appropriate number of physician contacts after being diagnosed with depression than patients with commercial health plans ( P = 0.008) and Medicaid ( P = 0.09). Similarly, a greater number of EHHOP patients had better acute phase ( P = 0.001; P = 0.096) and continuous phase ( P = 0.049; P = 0.88) pharmacologic treatment than patients with commercial health plans and Medicaid, respectively. EHHOP meets and, in some areas, exceeds the quality of depression treatment when compared to insured populations. Even though EHHOP already surpasses these indicators, the clinic can improve its diagnostic capabilities, prescription medication adherence, and referral care follow-through by creating an on-site mental health clinic.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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