Premium
Predictors of outpatient mental health clinic follow‐up after hospitalization among M edicaid‐enrolled young adults
Author(s) -
Marino Leslie,
Wissow Lawrence S.,
Davis Maryann,
Abrams Michael T.,
Dixon Lisa B.,
Slade Eric P.
Publication year - 2016
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12206
Subject(s) - medicine , medicaid , mental health , young adult , logistic regression , outpatient visits , psychiatry , ambulatory care , public health , outpatient clinic , health care , gerontology , nursing , economics , economic growth
Abstract Aim To assess demographic and clinical predictors of outpatient mental health clinic follow‐up after inpatient psychiatric hospitalization among M edicaid‐enrolled young adults. Methods Using logistic regression and administrative claims data from the M aryland public mental health system and M aryland M edicaid for young adults ages 18–26 who were enrolled in M edicaid (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 M edicaid‐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.