Caring for the Whole Person

NCT03034369 — Unknown, 6000 participants, Providence Health & Services

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Caring for the Whole Person: A Patient-Centered Assessment of Integrated Care Models in Vulnerable Populations

Registry	NCT03034369
Status	Unknown
Study type	Observational
Enrollment	6000 (Estimated)
Sponsor	Providence Health & Services (Other); collaborators: Patient-Centered Outcomes Research Institute, Oregon Health and Science University, Cascadia Addiction Research and Education, LLC, Umpqua Community Health Center, Mosaic Medical, North Portland Clinic, Providence Medical Group, Rockwood Clinic, The Bend Clinic, Yamhill CCO, The Annex, Cascadia Gardiner Clinic, Umpqua Expanded Care Clinic, Bridges Clinic
Conditions	Behavioral Health
Interventions	Access to Care, Depression Screening, Patient-Provider Relationship, Patient-Clinic Interactions, Stigma, Provider Continuity, Symptom Severity, Diagnoses, Social support, Preventive Screening, Inpatient Hospitalization Utilization, Inpatient Readmissions, Post-Admission follow-up (Other)
Dates	start 2015-03-01, primary completion 2017-12-01 (estimated), completion 2017-12-01 (estimated), first posted 2017-01-27, last updated 2017-06-15
Locations	1 site in United States

-Summary

The goal of this study is to identify outcomes associated with Behavioral Health Integration (BHI) that matter to patients, to compare changes in outcome over time to measure the impact of different BHI models on different patients, and to create and maintain an Integration Learning Collaborative.

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+Detailed description

Twelve safety net clinics have been selected to be a part of this study. The clinics vary on a BHI continuum level, which includes minimal collaboration, basic collaboration at a distance, basic collaboration on site, close collaboration (partially integrated) and close collaboration (fully integrated).

Twelve-thousand patients will be randomly selected from the 12 clinics to be invited to participate in the study. Patients who elect to participate will complete a survey at baseline to collect patient-reported outcomes and again twelve months later.

The Oregon All Providers All Claims (APAC) database will be accessed to analyze financial data regarding the patients at baseline and 12 months.

The hypothesis is that the degree of clinic BHI will predict patient outcomes.

+Arms and interventions

Arm	Type	Interventions	Description
Safety Net Clinic Patients		Other: Access to Care; Other: Depression Screening; Other: Patient-Provider Relationship; Other: Patient-Clinic Interactions; Other: Stigma; Other: Provider Continuity; Other: Symptom Severity; Other: Diagnoses; Other: Social support; Other: Preventive Screening; Other: Inpatient Hospitalization Utilization; Other: Inpatient Readmissions; Other: Post-Admission follow-up	A Cohort of patients in 12 different primary care clinics will be studied to measure how changes in different integration factors impacts the following patient reported outcomes at baseline and 12 months: Access to Care, Patient-Provider Relationship, Patient-Clinic Interactions, Stigma, Provider Continuity, Symptom Severity, Diagnoses, and Social Support. Health care claims data will be accessed to analyze Depression Screening, Preventive Screening, Inpatient Hospitalization Utilization, Inpatient Readmissions, and Post-Admission follow-up at baseline and 12 months.

Access to Care (Other): Patient reported outcome survey administered at baseline and 12 months to measure satisfaction with access to care.
Depression Screening (Other): Analysis of health care claims data for depression screenings at baseline and 12 months.
Patient-Provider Relationship (Other): Patient reported outcome survey administered at baseline and 12 months to measure satisfaction with patient-provider relationship.
Patient-Clinic Interactions (Other): Patient reported outcome survey administered at baseline and 12 months to measure satisfaction with patient-clinic interactions.
Stigma (Other): Patient reported outcome survey administered at baseline and 12 months to measure perceived stigma.
Provider Continuity (Other): Patient reported outcome survey administered at baseline and 12 months to measure satisfaction with provider continuity.
Symptom Severity (Other): Patient reported outcome survey administered at baseline and 12 months to measure symptom severity.
Diagnoses (Other): Patient reported outcome survey administered at baseline and 12 months to measure diagnoses.
Social support (Other): Patient reported outcome survey administered at baseline and 12 months to assess social support and outlets.
Preventive Screening (Other): Analysis of health care claims data for preventive screenings at baseline and 12 months.
Inpatient Hospitalization Utilization (Other): Analysis of health care claims data for Inpatient Hospitalization Utilization at baseline and 12 months.
Inpatient Readmissions (Other): Analysis of health care claims data for Inpatient Hospitalization Readmissions at baseline and 12 months.
Post-Admission follow-up (Other): Analysis of health care claims data for Post-Admission follow-up at baseline and 12 months.

+Outcome measures

Primary outcomes

Change in patient reported outcomes [12 months]: Change in patient reported outcomes at baseline and 12 months
Change in health care claims [12 months]: change in health care claims at baseline and 12 months

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Age >= 18
* Received care at a safety net care clinic in Oregon

Exclusion Criteria:

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+Locations (1)

Facility	City	Country	Status
Center for Outcomes Research and Education, Providence Health & Services	Portland, Oregon	United States

+Investigators

Bill J. Wright, PhD, Principal investigator, Director, Center for Outcomes Evaluate and Education, Providence Health & Services