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. 2023 Oct 1;74(10):1077-1080.
doi: 10.1176/appi.ps.20220428. Epub 2023 Apr 5.

One-Year All-Cause Mortality and Delivery of the Collaborative Chronic Care Model in General Mental Health Clinics

Michael A Ruderman  1 , Amy L Byers  1 , Mark S Bauer  1 , Kelly Stolzmann  1 , Christopher J Miller  1 , Samantha L Connolly  1 , Bo Kim  1
Affiliations

One-Year All-Cause Mortality and Delivery of the Collaborative Chronic Care Model in General Mental Health Clinics

Michael A Ruderman et al. Psychiatr Serv. .

Abstract

Objective: This study aimed to determine whether the evidence-based collaborative chronic care model (CCM) is associated with reduced all-cause mortality among adult patients treated in general mental health clinics.

Methods: Data came from a stepped-wedge, cluster-randomized CCM implementation trial across nine U.S. Department of Veterans Affairs medical centers. Survival analysis was used to estimate the relative effect of the treatment (N=5,570) compared with a control group (N=46,443) over 1 year.

Results: After adjustment for site-level and individual-level acute care utilization factors, analyses indicated that patients treated with the CCM experienced a reduction in all-cause mortality relative to patients in the control cohort (hazard ratio=0.76, 95% CI=0.60-0.95).

Conclusions: This study is the first in which CCM has been shown to reduce all-cause mortality for patients treated in general mental health clinics. Care delivery models should be considered part of efforts to reduce the life expectancy gap between individuals with psychiatric conditions and those without such conditions.

Keywords: Behavioral health; Collaborative chronic care model; Life expectancy; Medical morbidity and mortality; Service delivery systems; Team-based care.

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Conflict of interest statement

The authors report no financial relationships with commercial interests.

Figures

FIGURE 1.
FIGURE 1.
One-year unadjusted survival curves for all-cause mortality, by treatment cohorta aA: cumulative probability curves of dying from any cause over the 1-year trial period for the control and the collaborative chronic care model (CCM) cohorts. Shaded regions above and below survival curves represent 95% CIs. B: number of patients at each time point still at risk for premature death. Successive decreases over time reflect losses due to attrition or death.
See this image and copyright information in PMC

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