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Table 3 Outcomes for studies on integrated delivery of mental health and substance abuse services

From: Integration of priority population, health and nutrition interventions into health systems: systematic review

Type of outcome Study Measure Outcome (Intervention vs. Control)
Health outcomes Druss 2001 Change in physical component summary index. +4.7% vs. -0.3%, (p < 0.001)
   Change in mental component summary index. +2.4% vs. +2%, (p = 0.84)
  Krahn 2006 Change in Centre for Epidemiological Studies Depression scale (CES-D) score. Patients with all depression:
-6.0 ± 12.0 vs. -7.8 ± 11.8, (p = 0.07)
    Patients with major depression:
-7.5 ± 13.1 vs. -10.2 ± 12.1, (p = 0.003)
   Change in Medical Component Score (MCS). Patients with all depression:
+4.8 ± 12.6 vs. +4.9 ± 12.9, (p = 0.88)
    Patients with major depression:
+5.9 ± 12.6 vs. + 6.8 ± 12.8, (p = 0.32)
  Willenbring 1999 Number of patients with 2-year survival. 31/38 (81%) vs. 26/37 (70%), (p = 0.03)
Drug and alcohol use Oslin 2006 Change in number of drinks per week. -6.0 vs. -5.9 (p = 0.913)
   Change in number of binge episodes in the preceding three months. -8.5 vs. -10.2 (p = 0.750)
  Weisner 2001 Total abstinence and duration of abstinence. Non-SAMC patients:
66% vs. 73%, (p = 0.23)
    SAMC patients:
69% vs. 55%, (p = 0.006); period of abstinence 135 days vs. 122 days, (p = 0.05)
   Alcohol abstinence. Non-SAMC patients:
73% vs. 78% (p = 0.41)
    SAMC patients:
80% vs. 65%, (p = 0.002)
   Other drug abstinence Non-SAMC patients:
84% vs. 87%, (p = 0.50)
  Willenbring 1999 Number of patients with alcohol abstinence after 2 years. 28/38 (74%) vs. 17/36 (48%), (p = 0.02)
Patient satisfaction Druss 2001 Satisfaction score on 47-item questionnaire. Patients in integrated model were more satisfied with overall care received in 6 of 8 domains (access, attention to patient preferences, courtesy, coordination, continuity, and overall care) (p < 0.05 on all 6 domains)
  Gater 1997 Score on Client Satisfaction Questionnaire (range 1-4; low score indicates higher satisfaction). 1.86 vs. 2.23
Quality of care Druss 2001 Delivery of preventive measures outlined in clinical guidelines. Patients in integrated model (n = 59) more likely than in control group (n = 61) to receive 15 of 17 measures, (p < 0.01)
  Gater 1997 Number of clinical needs met; and unmet. 2.62 vs. 1.60, (p < 0.001);
0.57 vs. 1.62 (p < 0.001)
   Number of social needs met; and unmet. 1.83 vs. 1.49, (p = NS); 0.86 vs. 1.64 (p < 0.05)
  Watts 2007 Patients who screened positive for depression and received treatment in accordance with guidelines. From 1.1% to 11.2% vs. from 3.0% to 0.7%, (p < 0.001)
Utilisation of services Bartels 2004 Mean number of mental health and substance abuse visits. 3.04 vs. 1.91 (p ≤ 0.001)
   Appointment attendance. 71% vs. 48.8% (95% CI = 2.14 to 3.08)
  Druss 2001 Patients who used a medical: Primary care service; Specialty service;
Emergency department;
Inpatient service.
54/59 (91.5%) vs. 44/61 (72.1%), (p = 0.006);
41/59 (69.5%) vs. 41/61 (67.2%), (p = 0.17);
7/59 (11.9%) vs. 16/61 (26.2%), (p = 0.04);
5/59 (8.5%) vs. 11/61 (18%), (p = 0.12)
   Patients who used a mental health:
Outpatient service; Emergency department; Inpatient service.
58/59 (98.3%) vs. 61/61 (100%), (p = 0.31);
21/59 (35.6%) vs. 25/61 (41%), (p = 0.31);
8/59 (13.6%) vs. 10/61 (16.4%), (p = 0.66)
  Willenbring 1999 Mean number of IOT visits in 2 years. 42.2 ± 29.1 vs. 17.4 ± 15.6, (p < 0.001)
   Mean number of IOT visits in first and last 6 months of treatment. From 14 to 9 vs. 4-6 in both periods
Access to health care Watts 2007 Patients who screened positive and were able to access mental health services. 36.0% vs. 9%, (p < 0.001)
Cost Druss 2001 Mean cost per subject treated US$ 13,010 vs. US$ 14,543
  Gater 1997 Overall per capita health service cost £ 1,406 vs. £ 1,199
  Weisner 2001 Average cost of all treatment per month US$ 470.81 vs. US$ 427.95, (p = 0.14)