Benjamin G. Druss|Silke A. von Esenwein|Michael T. Compton|Kimberly J. Rask|Liping Zhao|Ruth M. Parker
A Randomized Trial of Medical Care Management for Community Mental Health Settings: The Primary Care Access, Referral, and Evaluation (PCARE) Study
Emory University
objective poor quality healthcare contributes impaired health excess mortality individuals severe mental disorders authors tested populationbased medical care management intervention designed improve primary medical care community mental health settings method total 407 subjects severe mental illness urban community mental health center randomly assigned either medical care management intervention usual care individuals intervention group care managers provided communication advocacy medical providers health education support overcoming systemlevel fragmentation barriers primary medical care results 12month followup evaluation intervention group received average 587 recommended preventive services compared rate 218 usual care group also received significantly higher proportion evidencebased services cardiometabolic conditions 349 versus 277 likely primary care provider 712 versus 519 intervention group showed significant improvement sf36 mental component summary 80 versus 11 decline usual care group nonsignificant improvement sf36 physical component summary among subjects available laboratory data scores framingham cardiovascular risk index significantly better intervention group 69 usual care group 98 conclusions medical care management associated significant improvements quality outcomes primary care findings suggest care management promising approach improving medical care patients treated community mental health settings