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Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic

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Abstract

To assess whether primary care medical homes (PCMHs) are accurately identified for patients receiving care in a specialty mental health clinic within an integrated public delivery system. This study reviewed the electronic records of patients in a large urban mental health clinic. The study defined ‘matching PCMH’ if the same primary care clinic was listed in both the mental health and medical electronic records. This study designated all others as ‘PCMH unknown.’ This study assessed whether demographic factors predicted PCMH status using chi-square tests. Among 229 patients (66% male; mean age 49; 36% White, 30% Black, and 17% Asian), 72% had a matching PCMH. Sex, age, race, psychiatric diagnosis, and psychotropic medication use were not associated with matching PCMH. To improve care coordination and health outcomes for people with severe mental illness, greater efforts are needed to ensure the accurate designation of PCMHs in all mental health patient electronic records.

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Funding

Dr. Garcia received support from National Institute of Health (NIH)/National Heart Lung and Blood Institute (NHLBI) grant K12HL138046, the Research in Implementation Science for Equity (RISE) Program, funded by NHLBI grant R25HL126146 and the Center for Aging in Diverse Communities (CADC) funded by NIH/National Institute of Aging (NIA) grant P30-AG015272. Dr. Thomas was partially supported by National Institute of General Medical Sciences (NIGMS) grant UL1GM118985, USA and by a Ford Foundation Predoctoral Fellowship administered by the National Academies of Sciences, Engineering, and Medicine, USA. Dr. Schillinger received support from NIH/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant 2P30 DK092924. Dr. Mangurian received support from NIH/National Institute of Mental Health (NIMH) grant K23MH093689. The contents of this manuscript are solely the responsibility of the authors an do not necessarily represent the official views of the NIA, NHLBI, NIDDK, NIMH, NIGMS, or the NIH.

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Author notes

  1. Maria E. Garcia and Elizabeth L. Goldman contributed equally to this work.

Authors and Affiliations

  1. Center for Aging in Diverse Communities, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, University of California, 1701 Divisadero St. Room 536, San Francisco, CA, USA

    Maria E. Garcia

  2. Division of General Internal Medicine, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA

    Elizabeth L. Goldman & Dean Schillinger

  3. Department of Epidemiology, University of California, Berkeley, CA, USA

    Marilyn Thomas

  4. Department of Medicine, University of California, Davis, CA, USA

    Stephen Chan

  5. Department of Psychiatry, University of California, San Francisco, CA, USA

    Fumi Mitsuishi

  6. Department of Psychiatry, San Francisco General Hospital, University of California, San Francisco, CA, USA

    Christina Mangurian

Authors
  1. Maria E. Garcia
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  2. Elizabeth L. Goldman
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  3. Marilyn Thomas
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  4. Stephen Chan
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  5. Fumi Mitsuishi
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  6. Dean Schillinger
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  7. Christina Mangurian
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Corresponding author

Correspondence to Maria E. Garcia.

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Conflict of Interest

The authors declare that they have no conflict to interest and all authors certify responsibility for the final manuscript.

Ethics Approval

This study was reviewed and approved by the University of California San Francisco Institutional Review Board (CHR# 14–14,610).

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Garcia, M.E., Goldman, E.L., Thomas, M. et al. Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic. Psychiatr Q 92, 601–607 (2021). https://doi.org/10.1007/s11126-020-09829-z

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  • DOI: https://doi.org/10.1007/s11126-020-09829-z

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