Date of Conferral

2021

Degree

Ph.D.

School

Nursing

Advisor

Leslie C. Hussey

Abstract

High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and reduced severity of anxiety symptoms compared to usual care (no IGMV attendance). The 2017-2018 records of a sample of 85 patients (43 IGMVs, 42 usual care) with anxiety diagnoses were reviewed from one U.S. racially/ethnically diverse health system database. Nonemergent ED utilization, BZD use, and anxiety symptom severity data were analyzed using repeated-measures analysis of variance. Results demonstrated that the IGMV group had no statistically significant difference in ED utilization (p = 0.82), BZD use (p = 0.67), and anxiety symptom severity (p = 0.89) compared to usual care. Future research could focus on cost-effectiveness studies of allopathic versus nonallopathic practitioners facilitating IGMVs for integrated behavioral health in the primary care home for low-income diverse populations. This study contributes to social change by adding to the literature on the effect of IGMV access on behavioral health and health outcomes for racially/ethnically diverse low-income patients.

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