The 130th Annual Meeting of APHA

Abstract #46219

Elaine J. Yuen, PhD¹, John L. Gerdes, PhD², and G. Craig Wood, MS². (1) Jefferson Medical College, Thomas Jefferson University, Suite 119, 1025 Walnut Street, Center for Research in Medical Education and Health Care, Philadelphia, PA 19107, 215-955-9405, elaine.yuen@mail.tju.edu, (2) Department of Psychiatry, Geisinger Health System, Geisinger Medical Center, Danville, PA 17822

OBJECTIVE: Collaboration between primary care (PC) and mental health (MH) providers has long been advocated as beneficial to patient care. In this study we examined the association between PC-MH collaboration and mental health care delivery and cost.

POPULATION: Patients over 18 years of age enrolled in the Geisinger Health Plan (GHP), an integrated rural and urban health care system in central Pennsylvania, and who used mental health services in 1996-1997 for the treatment of depression.

METHODS: We surveyed PC providers at 73 sites, and determined three separate collaboration factors. We then examined associations between collaboration factors, other site characteristics, and mental health service use in hospital, outpatient, and emergency room settings. Paid claims and enrollee data from GHP were used to develop measures of MH encounters per thousand enrollees, the percent of members per site with a MH encounter, and total MH charges.

FINDINGS: Sites with higher scores on collaborative relationship quality had fewer members who used the ER for mental health services, although higher collaboration frequency was associated with higher ER charges. More use of outpatient MH providers was associated with higher primary care physician knowledge scores about MH, as well as a higher level of collaboration frequency. The availability of an onsite MH provider was associated with less use of other outpatient providers for MH treatment.

CONCLUSIONS: Stronger dimensions of PC-MH provider collaboration were associated with lower use of ER and more use of outpatient MH services. Collaboration may facilitate coordination of care with treatment in less intensive settings.

Learning Objectives:

• (1)to become familiar with models of collaboration between mental health and primary care providers (2)to be able to discuss how PC-MH provider collaboration is associated with mental health service use outcomes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.