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Behavioural health interventions in the Johns Hopkins Community Health Partnership: Integrated care as a component of health systems transformation

机译：约翰·霍普金斯社区卫生伙伴关系中的行为健康干预措施：综合护理作为卫生系统转型的一部分

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Health systems in the USA have received a mandate to improve quality while reining in costs. Several opportunities have been created to stimulate this transformation. This paper describes the design, early implementation and lessons learned for the behavioural components of the John Hopkins Community Health Partnership (J-CHiP) programme. J-CHiP is designed to improve health outcomes and reduce the total healthcare costs of a group of high healthcare use patients who are insured by the government-funded health insurance programmes, Medicaid and Medicare. These patients have a disproportionately high prevalence of depression, other psychiatric conditions, and unhealthy behaviours that could be addressed with behavioural interventions. The J-CHiP behavioural intervention is based on integrated care models, which include embedding mental health professionals into primary sites. A four-session behaviour-based protocol was developed to motivate self-efficacy through illness management skills. In addition to staff embedded in primary care, the programme design includes expedited access to specialist psychiatric services as well as a community outreach component that addresses stigma. The progress and challenges involved with developing this programme over a relatively short period of time are discussed.
机译：美国的卫生系统已受命在降低成本的同时提高质量。已经创造了一些机会来刺激这种转变。本文介绍了约翰·霍普金斯社区卫生合作计划（J-CHiP）计划的行为组成部分的设计，早期实施和经验教训。 J-CHiP旨在改善健康状况，并降低由政府资助的医疗保险计划Medicaid和Medicare保障的一组高医疗保健用途患者的总医疗费用。这些患者的抑郁症，其他精神疾病和不健康行为的比例过高，可以通过行为干预来解决。 J-CHiP行为干预基于综合护理模型，其中包括将精神卫生专业人员嵌入主要场所。制定了基于行为的四个阶段的协议，以通过疾病管理技能来激发自我效能。除了基层医疗人员之外，该计划的设计还包括加快获得专科精神病服务的机会以及解决耻辱感的社区外展服务。讨论了在相对较短的时间内开发此程序所涉及的进展和挑战。

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