خط مشی دسترسی
پرسش و پاسخ
Personal Name - Primary Intelectual Responsibility
Mullin, Daniel Joseph
Title and statement of responsibility
An evaluation of an integrated primary care demonstration project [Thesis]
Language of Text,Soundtrack etc.
Dissertation of thesis details and type of degree
Summary or Abstract
Integrated Primary Care (IPC) models of service delivery are potentially powerful population-based approaches to care which have been shown to successfully improve health status and reduce costs. IPC programs integrating behavioral health and primary care are becoming increasingly prevalent. Models and processes for integrating care have been well articulated. However, standardized modalities for the evaluation of IPC at the programmatic level have not been widely applied. A standardized assessment of an IPC program was proposed with four specific aims: (1) to provide a summary of the IPC program's existing patient population characteristics; (2) to review results of a comprehensive needs assessment conducted with both the patients and providers of the primary care practice housing the IPC program; (3) the standardized assessment of the IPC program regarding its degree of compliance with an ideal IPC model (4) to provide a series of global and specific recommendations for further program development or modifications informed by the evaluation. The standardized programmatic assessment process was adapted from Strosahl's 1997 Sample Report Card for IPC Behavioral Health Programs. The IPC program chosen for the evaluation was a Demonstration Project located in a primary care clinic serving urban-dwelling, low-SES, medically underserved patients (N=198, Mean age=55, SD=16; 59 female, 80 African American). Data were gathered from the Demonstration Project's development proposal, clinician interviews, and aggregate data on the patient sample served during the demonstration project. Five graduate psychology student raters, with limited previous IPC knowledge or experience, viewed a confederate lead standardized presentation and were instructed on procedures for rating the Demonstration Project on the Report Card's eight separate dimensions measuring the degree of program integration. Overall inter-rater agreement across dimensions was somewhat low (Krippendorff's Alpha=.43). Findings may differ in established programs with different patient demographics. A revised 13-dimension report card is proposed which may result in greater specificity and accuracy of evaluation. IPC program planners should consider a priori system-wide program evaluations based on dimensions proposed by this type of standardized format..
Topical Name Used as Subject
Mental health, Surgery, Psychotherapy
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