The Mood Disorders Association of British Columbia Psychiatric Urgent Care Program: A Preliminary Evaluation of a Suggested Alternative Model of Outpatient Psychiatric Care
Free accessResearch articleFirst published online April, 2014
The Mood Disorders Association of British Columbia Psychiatric Urgent Care Program: A Preliminary Evaluation of a Suggested Alternative Model of Outpatient Psychiatric Care
To describe an alternative model of psychiatric outpatient care for patients with mood and anxiety disorders (the Mood Disorders Association of British Columbia Psychiatric Urgent Care Program or the MDA Program) using group medical visits (GMV) and (or) email communications in lieu of individual follow-up appointments.
Method:
Annual costs of the MDA Program were compared with average costs of private psychiatrists offering outpatient care and patients being treated in a mental health centre. In addition, questionnaires as to patient satisfaction with the MDA Program intake, GMV experience, and family physician satisfaction with the MDA Program were administered.
Results:
The MDA Program model of care is significantly more cost effective than individual psychiatric outpatient care or health authority mental health centre care for patients with moderate or severe illness. Patients and family physicians were very satisfied with the model of care and GMVs offered.
Conclusions: The MDA Program model of care appears to be efficient and cost-effective, and patients and referring physicians appear satisfied with the care offered in this program.
British Columbia Medical Association (BCMA). Stepping out of the shadows: Collaboration to improve services for patients with depression [Internet].Vancouver (BC): BCMA; 2009 [cited 2010 Oct 2]. Available from: http://www.bcma.org.
2.
GoldnerEMJonesWFangML. Access to and waiting time for psychiatric services in a Canadian urban area: A study in real time. Can J Psychiatry. 2011;56(8):474–480.
3.
GuyW, editor. ECDEU assessment manual for psychopharmacology. Rockville (MD): US Department of Health, Education, and Welfare; 1976.
4.
KellyBJFrazeTKHornikRC. Response rates to a mailed survey of a representative sample of cancer patients randomly drawn from the Pennsylvania Cancer Registry: A randomized trial of incentive and length effects. BMC Med Res Methodol. 2010;10(65):1–10.
5.
FlaniganTSMcFarlaneECookS.Conducting survey research among physicians and other medical professionals—a review of current literature. AAPOR Section on Survey Research Methods. 2008:4136–4147.
6.
RemickRARemickAK. Do patients really prefer individual outpatient follow-up visits compared with group medical visits?Can J Psychiatry. 2014;39(1)50–53.
7.
BeckAScottJWilliamsP, A randomized trial of group outpatient visits for chronically ill older HMO members: The cooperative health care clinic. J Am Geriatr Soc. 1997;45(5):543–549.
8.
CohenLBTavieraTHKhatanaSA, Pharmacist-led shared medical appointments for multiple cardiovascular risk reduction in patients with type 2 diabetes. Diabetes Educ. 2011;37(6):801–812.
9.
DorseyERDeuelLMBeckCA, Group patient visits for Parkinson disease: A randomized feasibility trial. Neurology. 2011;76(16):1542–1547.
10.
GellerJSOrkabyACleghornGD. Impact of a group medical visit program on Latino health-related quality of life. Explore. 2011;7(2):94–99.
11.
JaberRBraksmajerATrillingJS. Group visits: A qualitative review of current research. J Am Board Fam Med. 2006;19(3):276–290.
12.
KirshSWattsSPascuzziK, Shared medical appointments based on the chronic care model: A quality improvement project to address the challenges of patients with diabetes with high cardiovascular risk. Qual Saf Health Care. 2007;16(4):349–353.
13.
MeehanKRHillJMRootL, Group medical appointments: Organization and implementation in the bone marrow transplantation clinic. Support Cancer Ther. 2006;3(2):84–90.
14.
ScottJCConnerDAVenohrI, Effectiveness of a group outpatient visit model for chronically ill older health maintenance organization members: A 2-year randomized trial of the cooperative health care clinic. J Am Geriatr Soc. 2004;52(9):1463–1470.
15.
SeesingFMDrostGvan der WiltGJ, Effects of shared medical appointments on quality of life and cost-effectiveness for patients with a chronic neuromuscular disease. Study protocol of a randomized trial. BMC Neurol. 2011;11(106):1–9.
16.
TaveiraTHFriedmannPDCohenLB, Pharmacist-led group medical appointment model in type 2 diabetes. Diabetes Educ. 2010;36(1):109–117.
17.
TaveiraTHDooleyAGCohenLB, Phamacist-led group medical appointments for the management of type 2 diabetes with comorbid depression in older adults. Ann Pharmacother. 2011;45(11):1346–1355.
18.
BastienCHMorinCHOuelletM, Cognitive-behavioral therapy for insomnia: Comparison of individual therapy, group therapy, and telephone consultations. J Consult Clin Psychol. 2004;72(4):653–659.
19.
FolkersKvan RijnJAppeloM.A literature review of the efficacy of individual versus group cognitive behavior therapy. Behav Ther. 2007;40(3):177–199. Dutch translation.
20.
JónssonHHougaardEBennedsenBE. Randomized comparative study of group versus individual cognitive behavioural therapy for obsessive compulsive disorder. Acta Psychiatr Scand. 2011;123(3):387–397.
21.
LubinH.Group and individual therapy for childhood sexual abuse survivors. Int J Group Psychother. 2007;57(2):257–262.
22.
ShechtmanZ.Therapeutic factors and outcomes in group and individual therapy of aggressive boys. Group Dyn. 2003;7(3):225–237.
23.
NoffsingerEB. Running group visits in your practice. New York (NY): Springer Science + Business Media; 2009.
24.
SeemanMVSeemanB.E-psychiatry: The patient-psychiatrist relationship in the electronic age. CMAJ. 1999;161(9):1147–1149.
25.
SeemanMVSeemanMSeemanB, E-psychiatry using web-based communications to connect with patients. Psychiatr Times. 2010;27(2):18–22.
26.
BoukusERGrossmanJMO'MalleyAS. Physicians slow to e-mail routinely with patients. Issue Brief Cent Stud Health Syst Change. 2010;134:1–5.
27.
SivaCLawlorKSmarrK, E-mail communication with patients: A survey of the American College of Physicians, Missouri Chapter. Mo Med. 2011;108(2):136–140.
28.
BaerD.Patient-physician e-mail communication: The Kaiser Permanente experience. J Oncol Pract. 2011;7(4):230–233.
29.
RosenPKwohK.Patient-physician e-mail: An opportunity to transform pediatric health care delivery. Pediatrics. 2007;120(4):701–706.
30.
SimonGERalstonJDSavarinoJ, Randomized trial of depression follow-up care by online messaging. J Gen Intern Med. 2011;26(7):698–704.
31.
ZhouYYKanterMHWangJJ, Improved quality at Kaiser Permanente through e-mail between physicians and patients. Health Aff (Millwood). 2010;29(7):1370–1375.
