PRESENTACIÓN

A través de este Blog pretendemos generar un espacio para el intercambio fluido de información y reflexiones acerca del tema de Salud Mental y Atención Primaria en Salud (APS) por su especial relevancia para un País como Colombia y el interés que genera en investigadores, profesionales de la salud y comunidades. En este espacio podemos compartir bibliografía, documentos técnicos, informes de gestión, propuestas o resultados de investigaciones, desarrollos curriculares, modelos de implementación, reflexiones, preguntas, e información acerca de fuentes de asistencia técnica y financiación, entre otros.


Este Blog surge como resultado del proceso de reflexión grupal que se originó a partir de la Actividad Pre-Congreso en Atención Primaria en Salud Mental llevada a cabo el 11 de Junio de 2009 en Medellín como parte del 6º Congreso Internacional de Salud Pública con la participación de 117 personas y 41 instituciones a lo largo del territorio nacional.


Los invitamos a que se registren y comiencen a hacer uso activo de este Blog en el cual ya se encuentran publicadas las Memorias del Pre-Congreso. Sus ideas acerca de las mejores maneras de aprovechar este Blog son bienvenidas.


Sergio Cristancho Marulanda, PhD
Coordinador Grupo de Investigación en Salud Mental


Erika María Montoya, MSP
Coordinadora Área de Desarrollo Académico en Comportamiento Humano y Salud


Facultad Nacional de Salud Pública
Universidad de Antioquia
Calle 62 No. 52-59
Medellín, Colombia

viernes, 14 de mayo de 2010

Evolving Models of Behavioral Health Integration in Primary Care

Chris Collins, Denise Levis Hewson, Richard Munger, and Torlen Wade

The Milbank Memorial Fund - May 2010

PDF file [102p.] at:

http://www.milbank.org/reports/10430EvolvingCare/EvolvingCare.pdf

“…..This report offers an approach to meeting the unmet needs of the millions of Americans suffering from mental illness and substance abuse: the integration of primary care and behavioral health care.

The report summarizes the available evidence and states’ experiences around integration as a means for delivering quality, effective physical and mental health care. For those interested in integrating care, it provides eight models that represent qualitatively different ways of integrating/coordinating care across a continuum—from minimal collaboration to partial integration to full integration—according to stakeholder needs, resources, and practice patterns

This report also provides an orientation to the field and, hopefully, a compelling case for integrated or collaborative care. It provides a concise summary of the various models and concepts and describes, in further detail, eight models that represent qualitatively different ways of integrating and coordinating care across a continuum—from minimal collaboration to partial integration to full integration. Each model is defined and includes examples and successes, any evidence-based research, and potential implementation and financial considerations.

Also provided is guidance in choosing a model as well as specific information on how a state or jurisdiction could approach integrated care through steps or tiers. Issues such as model complexity and cost are provided to assist planners in assessing integration opportunities based on available resources and funding. The report culminates with specific recommendations on how to support the successful development of integrated care. ….”

Table of Contents

Foreword

  • Acknowledgments

  • Executive Summary

  • Introduction—Making the Case for Integrated Care

  • Orientation to the Field

  • Information Technology

  • Practice Models of Integration

  • Practice Model 1: Improving Collaboration between Separate Providers

  • Practice Model 2: Medical-Provided Behavioral Health Care

  • Practice Model 3: Co-location

  • Practice Model 4: Disease Management

  • Practice Model 5: Reverse Co-location

  • Practice Model 6: Unified Primary Care and Behavioral Health

  • Practice Model 7: Primary Care Behavioral Health

  • Practice Model 8: Collaborative System of Care

  • Considerations for Choosing a Model

  • Incremental Steps in a Challenging Fiscal Environment

  • Recommendations for Health Care Delivery System Redesign to Support Integrated Care

  • Conclusion

  • Resources -- References

List of Tables

  • Table 1: Four Quadrants of Clinical Integration Based on Patient Needs

  • Table 2: Using Information Technology to Integrate Care

  • Table 3: Collaborative Care Categorizations at a Glance

  • Table 4: Examples of Practice Model 1—Improving Collaboration between Separate Providers

  • Table 5: Examples of Practice Model 2—Medical-Provided Behavioral Health Care

  • Table 6: Examples of Practice Model 3—Co-location

  • Table 7: Examples of Practice Model 4—Disease Management

  • Table 8: Examples of Practice Model 5—Reverse Co-location

  • Table 9: Examples of Practice Model 6—Unified Primary Care and Behavioral Health

  • Table 10: Examples of Practice Model 7—Primary Care Behavioral Health

  • Table 11: Examples of Practice Model 8—Collaborative System of Care

  • Table 12: Summary of Primary Care–Behavioral Health Integration Models

  • Table 13: Incremental Steps for Integrating Care

* * *

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