Predictors of outpatient mental health clinic follow-up after hospitalization among Medicaid-enrolled young adults
Department of Psychiatry, Systems and Psychosocial Advances Research Center
Health Services Administration | Health Services Research | Mental and Social Health | Psychiatry | Psychiatry and Psychology
AIM: To assess demographic and clinical predictors of outpatient mental health clinic follow-up after inpatient psychiatric hospitalization among Medicaid-enrolled young adults.
METHODS: Using logistic regression and administrative claims data from the Maryland public mental health system and Maryland Medicaid for young adults ages 18-26 who were enrolled in Medicaid (N = 1127), the likelihood of outpatient mental health follow-up within 30 days after inpatient psychiatric hospitalization was estimated .
RESULTS: Only 51% of the young adults had any outpatient mental health follow-up visits within 30 days of discharge. Being black and having a co-occurring substance use disorder diagnosis were associated with a lower probability of having a follow-up visit (OR = 0.60, P < 0.01 and OR = 0.36, P < 0.01, respectively). In addition, those who utilized any outpatient public mental health services during the 180 days prior to their index hospitalization (N = 625, 55.4%) were more likely to have a follow-up visit than those without prior outpatient use (OR = 2.45, P < 0.01). Prior Medicaid-reimbursed primary care visits were not significantly associated with follow-up.
CONCLUSIONS: In this predominantly urban, low-income statewide sample of young adults hospitalized for serious psychiatric conditions, half did not connect with an outpatient mental healthcare provider following their discharge. Outpatient transition supports may be especially needed for young adults who were not receiving outpatient services prior to being admitted for psychiatric inpatient care, as well as for young adults with substance use disorders and African Americans.
Medicaid, mental health service, young adult
DOI of Published Version
Early Interv Psychiatry. 2016 Dec;10(6):468-475. doi: 10.1111/eip.12206. Epub 2015 Jan 13. Link to article on publisher's site
Early intervention in psychiatry
Marino L, Wissow LS, Davis M, Abrams MT, Dixon LB, Slade EP. (2016). Predictors of outpatient mental health clinic follow-up after hospitalization among Medicaid-enrolled young adults. Psychiatry Publications. https://doi.org/10.1111/eip.12206. Retrieved from https://escholarship.umassmed.edu/psych_pp/716