Integrated Behavioral Health in Primary Care Residency and Nonresidency Practices

Area of Science:

• Primary Care Research
• Health Services Research
• Behavioral Health Integration

Background:

• Integrated behavioral health (BH) is a preferred primary care model, enhancing patient outcomes and satisfaction.
• Limited data exist on BH integration levels in residency versus nonresidency primary care practices.
• This study addresses the gap by comparing BH integration in these practice types.

Purpose of the Study:

• To compare behavioral health integration levels between primary care residency and nonresidency practices.
• To assess differences in patient health outcomes and satisfaction with care across practice types.
• To inform strategies for disseminating integrated BH in primary care.

Main Methods:

• A cluster-randomized, pragmatic trial involving 44 primary care practices (18 residency, 26 nonresidency) and 4,007 adult patients with chronic conditions.
• Data collected in 2018-2019 included BH integration (Practice Integration Profile), patient health outcomes (PROMIS-29), and patient satisfaction (Consultation and Relational Empathy scale).
• Multivariate regression analyses compared outcomes between residency and nonresidency practices.

Main Results:

• No significant differences were found in BH integration levels between residency and nonresidency practices.
• Patient health outcomes and satisfaction with care were comparable across both practice types.
• Residency practices demonstrated similar BH integration and patient outcomes to nonresidency practices.

Conclusions:

• Primary care practices with residency programs exhibit comparable BH integration, patient health outcomes, and satisfaction to those without residency programs.
• Both residency and nonresidency practices require targeted interventions and resources to overcome challenges in achieving high levels of BH integration.
• Findings suggest that integrated BH models are similarly effective in residency and nonresidency settings.