Online Program

Positive outcomes for SPMI patients receiving integrated care in a multi-state study

Monday, November 2, 2015 : 9:30 a.m. - 9:50 a.m.

Tessa Miracle, M.A., College of Education and Human Services, Wright State University, Dayton, OH
Nicole Kinzeler, Ph.D, Substance Abuse Resources and Disability Issues (SARDI), Boonshoft School of Medicine, Wright State University, Kettering, OH
Kelly Firesheets, Psy.D, Interact for Health, Cincinnati, OH
Josephine Wilson, DDS, PhD, Substance Abuse Resources and Disability Issues (SARDI), Boonshoft School of Medicine, Wright State University, Kettering, OH
Background: Severely and persistently mentally ill (SPMI) individuals die 25 years earlier, on average, than the general population. Poor access to medical care and elevated rates of chronic conditions contribute to shortened lifespans for this population.  In response to this problem, community mental health and federally qualified health centers in Ohio, Indiana, and Kentucky partnered to integrate primary care and behavioral health services for SPMI individuals. Methods:  Adult SPMI patients in the Greater Cincinnati area received coordinated medical, behavioral health, and prevention services from one of six integrated-care clinics. Outcome measures including hemoglobin A1c levels, cholesterol (LDL-C) levels, blood pressure, depression (PHQ-9) scores, and body mass index (BMI) were obtained from January 2012 through December 2014. ANOVAs and t-tests were conducted to assess change from baseline to follow-up. Results: Data were collected from 2,220 SPMI patients receiving integrated services.  Eighteen percent of patients presented with diabetes, 44% with hypertension, 33% with hyperlipidemia, and 75% had a BMI > 25. Patients showed significant improvement in blood pressure, LDL-C, and PHQ-9 score from baseline to follow-up (p’s<0.001).  Patients who received integrated care for greater than one year showed significantly more improvement in outcome measures than those patients who received integrated services for less than one year (p’s<0.05). Conclusions: SPMI patients in this region experienced poorer physical health compared to the general population in the same counties. Providing SPMI patients with integrated care positively impacted their health, supporting an important role for health integration in the prevention and treatment of chronic conditions in this population.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Discuss an evaluation plan for integrated healthcare Identify health disparities that the severely and persistently mentally ill (SPMI) population experiences Discuss the impact of integrated healthcare on the physical and mental health of SPMI patients

Keyword(s): Medical Care, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the lead evaluator on the integrated care project for the past three years. I have played a primary role in data collection, analysis, and report writing. My research interests include integrated care, medical compliance, and health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3060.0: Integrated care