Trial reportThe American journal of psychiatry2011
Budget impact and sustainability of medical care management for persons with serious mental illnesses.
Trial report in The American journal of psychiatry, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings.Frontiers in health services · 2025Pooled it
- Built to last? The sustainability of healthcare system improvements, programmes and interventions: a systematic integrative review.BMJ open · 2020Pooled it
- Pooled it
- Effectiveness of embedding a specialist preventive care clinician in a community mental health service in increasing preventive care provision: A randomised controlled trial.The Australian and New Zealand journal of psychiatry · 2020Trial
- An economic evaluation of a specialist preventive care clinician in a community mental health service: a randomised controlled trial.BMC health services research · 2020Trial
- Impact of schizophrenia on coronary artery bypass grafting outcomes: a nationwide analysis.Annals of medicine and surgery (2012) · 2026Article
- Variability in documentation of neurological and psychiatric examinations among emergency department patients with behavioral health-related presentations: a retrospective study.Frontiers in psychiatry · 2026Article
- Article
- Sustainability of healthcare professionals' adherence to clinical practice guidelines in primary care.BMC primary care · 2022Article
- An integrative collaborative care model for people with mental illness and physical comorbidities.International journal of mental health systems · 2020Article
- Utilization of the Behavior Change Wheel framework to develop a model to improve cardiometabolic screening for people with severe mental illness.Implementation science : IS · 2017Article
- Developing the Business Case and Supporting Practice Change for Collaborative Care.Focus (American Psychiatric Publishing) · 2017Article
- Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care.The Permanente journal · 2017Article
- Recommendations for Primary Care Provided by Psychiatrists.Community mental health journal · 2016Article
- Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support.Implementation science : IS · 2015Article
- Oregon's Medicaid Transformation: An Innovative Approach To Holding A Health System Accountable For Spending Growth.Healthcare (Amsterdam, Netherlands) · 2014Article
- Integrating bipolar disorder management in primary care.Current psychiatry reports · 2012Review
- Physical Examinations of Psychiatric Patients who Presented at the Emergency Department of a Tertiary-Care Hospital in Oman.Saudi journal of medicine & medical sciencesArticle
- Integrating physical health: What were the costs to behavioral health care clinics?General hospital psychiatryArticle
Corrections and comments
- Commented on byIntegrated care.2011
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe authors assessed the 2-year outcomes, costs, and financial sustainability of a medical care management intervention for community mental health settings.
methodA total of 407 psychiatric outpatients with serious mental illnesses were randomly assigned to usual care or to a medical care manager who provided care coordination and education. Two-year follow-up chart reviews and interviews assessed quality and outcomes of care, as well as costs from both the health system and managerial perspectives.
resultsSustained improvements were observed in the intervention group in quality of primary care preventive services, quality of cardiometabolic care, and mental health-related quality of life. From a health system perspective, by year 2, the mean per-patient total costs for the intervention group were $932 (95% CI=-1,973 to 102) less than for the usual care group, with a 92.3% probability that the program was associated with lower costs than usual care. From the community mental health center perspective, the program would break even (i.e., revenues would cover setup costs) if 58% or more of clients had Medicaid or another form of insurance. Given that only 40.5% of clients in this study had Medicaid, the program was not sustainable after grant funding ended.
conclusionsThe positive long-term outcomes and favorable cost profile provide evidence of the potential value of this model. However, the discrepancy between health system and managerial cost perspectives limited the program's financial sustainability. With anticipated insurance expansions under health reform, there is likely to be a stronger business case for safety net organizations considering implementing evidence-based interventions such as the one examined in this study.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.