http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-2.xsd
Access to behavioral health care for geographically remote service members and dependents in the U.S
With many service members now returning to the United States from the recent conflicts in Iraq and Afghanistan, concern over adequate access to behavioral health care (treatment for mental, behavioral, or addictive disorders) has risen. Yet data remain very sparse regarding how many service members (and their dependents) reside in locations remote from behavioral health providers, as well as the resulting effect on their access to and utilization of care. Little is also known about the effectiveness of existing policies and other efforts to improve access to services among this population. To help fill these gaps, a team of RAND researchers conducted a geospatial analysis using TRICARE and other data, finding that roughly 300,000 military service members and 1 million dependents are geographically distant from behavioral health care, and an analysis of claims data indicated that remoteness is associated with lower use of specialty behavioral health care. A review of existing policies and programs discovered guidelines for access to care, but no systematic monitoring of adherence to those guidelines, limiting their value. RAND researchers recommend implementing a geospatial data portal and monitoring system to track access to care in the military population and mark progress toward improvements in access to care. In addition, the RAND team highlighted two promising pathways for improving access to care among remote military populations: telehealth and collaborative care that integrates primary care with specialty behavioral care.
Cover; Title Page; Copyright; Preface; Contents; Figures; Tables; Summary; Acknowledgments; Abbreviations; CHAPTER ONE: Introduction; CHAPTER TWO: Scope of the Problem: How Many Service Members and Dependents Are Remote, and Who Are They?; Data Sources for Location of Service Members and Providers; A Working Definition of Remoteness; Data Analysis: Implementing the Remoteness Definition; Summary; CHAPTER THREE: Effects of Remoteness on Civilian Behavioral Health Care Use; Rural and Urban Differences in Use of Behavioral Health Care; Analysis of the National Survey of Drug Use and Health.
Analysis of Health Care Use in the National Study of Drug Use and HealthExplanations for Rural-Urban Disparities in Behavioral Health Care; Summary; CHAPTER FOUR: Effects of Remoteness on Military Behavioral Health Care Use; Prospective Analysis of Remoteness and Behavioral Health Care Use; Summary; CHAPTER FIVE: Barriers and Gaps in Policy and Practice; Interviews with Key Experts; Summary of Findings from Expert Interviews; Policy Review; Summary; CHAPTER SIX: Clinical and System Approaches for Improving Access for Remote Populations.
Integration of Behavioral Health Treatment into Primary CareTelemental Health as a Potential Partial Solution; Issues Affecting Access to Telemental Health; CHAPTER SEVEN: Recommendations; APPENDIXES; A. Defense Enrollment Eligibility Reporting System Personnel Data; B. Driving Distance to Military Treatment and Veterans Affairs Facilities; C. Community Provider Shortage Areas; D. ZIP Code File for Geospatial Analysis; E. TRICARE Plans; F. National Study of Drug Use and Health Utilization Analyses; G. TRICARE Claims Data.; H. Review of the Effectiveness of Telemental Health.
Ryan Andrew Brown, Grant N. Marshall, Joshua Breslau, Coreen Farris, Karen Chan Osilla, Harold Alan Pincus, Teague Ruder, Phoenix Voorhies, Dionne Barnes-Proby, Katherine Pfrommer, Lisa Miyashiro, Yashodhara Rana, David M. Adamson.