Integrated care coordination by an interprofessional team reduces emergency department visits and hospitalisations at an academic health centre

ABSTRACT

People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents. We then evaluated the clinical effectiveness of this programme by describing participants’ healthcare utilisation patterns pre- and post-enrolment. Patients enrolled in the programme were approximately 60–70% less likely to utilise the emergency room and 50% less likely to be admitted to the hospital after enrolment in the programme compared to before enrolment. The odds of individual attendance at outpatient primary care and mental health visits improved after enrolment. In the context of the implementation of integrated behavioural and physical healthcare in primary care, this interprofessional care management programme reduced emergency department utilisation and hospitalisations while improving utilisation of primary care and psychiatry outpatient care. Further studies should focus on replication of this model to further discern the model’s cost-savings and health promotion effects.

KEYWORDS:

• Evaluation research
• integration
• interprofessional education
• team-based care

Acknowledgements

We would like to thank Josephine Bowers, Rachael Edelen, Kate Jansen, and Alison Lynch for their contributions to this article.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

This work was funded by the Health Resources & Services Administration Residency Training in Primary Care Programme (HRSA-11-156).

Notes

^1. The term integrated care is used to describe specifically the integration of behavioural and physical healthcare; these models are being widely implemented in the United States, and it is a current hot topic. Here, the care team is not just interprofessional; the care delivered is integrated and includes behavioural and physical health.

Additional information

Funding

This work was funded by the Health Resources & Services Administration Residency Training in Primary Care Programme (HRSA-11-156).