Potentially Preventable Medical Hospitalizations Among Maryland Residents With Mental Illness, 2005–2010

McGinty, Emma E.; Sridhara, Srinivas

doi:10.1176/appi.ps.201300323

Cited by 11 publications

(9 citation statements)

References 12 publications

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“…Increased ACS-specific utilization among populations of consumers with mental illness has been shown in prior research. Authors of a study of Maryland Medicaid data found that mental illness was associated with 32% higher odds of experiencing an ACS-specific hospital admission among adults aged 18-64, as well as among children and older adults (McGinty & Sridhara, 2014). These findings confirmed the findings from two previous studies in the SMI population regarding the prevalence of ACS-specific conditions in mental illness (Cahoon, McGinty, Ford, & Daumit, 2013;Li, Glance, Cai, & Mukamel, 2008).…”

Section: Data For Hospital Admissions and Readmissions In 2012 From Tsupporting

confidence: 71%

“…I found very little ACS-specific utilization, with just two inpatient admissions and two ED visits in the sample during the one year study timeframe. Although the same ICD-9-CM codes were used to identify ACS-specific utilization as in prior research, authors of the prior studies used administrative claims data with primary and secondary diagnoses codes as the basis for analysis (Cahoon et al, 2013;Li et al, 2008;McGinty & Sridhara, 2014). I relied on ICD-9-CM codes on authorization data provided to the CMHC from two health plans, and there was only one code (the primary diagnosis code) per authorization.…”

Section: Data For Hospital Admissions and Readmissions In 2012 From Tmentioning

confidence: 99%

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Evaluating the Impact of Integrated Care on Service Utilization in Serious Mental Illness

Waters

Furukawa

Jorissen

2018

Community Ment Health J

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Serious mental illness (SMI) affects 5% of the United States population and is associated with increased morbidity and mortality, and use of high-cost healthcare services including hospitalizations and emergency department visits. Integrating behavioral and physical healthcare may improve care for consumers with SMI, but prior research findings have been mixed. This quantitative retrospective cohort study assessed whether there was a predictive relationship between integrated healthcare clinic enrollment and inpatient and emergency department utilization for consumers with SMI when controlling for demographic characteristics and disease severity. While findings indicated no statistically significant impact of integrated care clinic enrollment on utilization, the sample had lower levels of utilization than would have been expected. Since policy and payment structures continue to support integrated care models, further research on different programs are encouraged, as each setting and practice pattern is unique.

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Section: Data For Hospital Admissions and Readmissions In 2012 From Tsupporting

confidence: 71%

Section: Data For Hospital Admissions and Readmissions In 2012 From Tmentioning

confidence: 99%

Evaluating the Impact of Integrated Care on Service Utilization in Serious Mental Illness

Waters

Furukawa

Jorissen

2018

Community Ment Health J

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“…Medical comorbidity and premature mortality in MH care is a global problem (Liu et al ., 2017). An association between MH conditions and preventable hospital admissions has been demonstrated in diverse health care settings in the USA (Yoon et al ., 2012; McGinty and Sridhara, 2014; Medford-Davis et al ., 2018; Schmidt et al ., 2018; Stockbridge et al ., 2019), Denmark (Davydow et al ., 2015, 2016), Taiwan (Lin et al ., 2011) and Scotland (Payne et al ., 2013). However, our specific findings may not generalise to the health systems of other countries.…”

Section: Discussionmentioning

confidence: 99%

Potentially preventable hospitalisations for physical health conditions in community mental health service users: a population-wide linkage study

Sara

Chen

Ramanuj

et al. 2021

Epidemiol Psychiatr Sci

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Aims Mental health (MH) service users have increased prevalence of chronic physical conditions such as cardio-respiratory diseases and diabetes. Potentially Preventable Hospitalisations (PPH) for physical health conditions are an indicator of health service access, integration and effectiveness, and are elevated in long term studies of people with MH conditions. We aimed to examine whether PPH rates were elevated in MH service users over a 12-month follow-up period more suitable for routine health indicator reporting. We also examined whether MH service users had increased PPH rates at a younger age, potentially reflecting the younger onset of chronic physical conditions. Methods A population-wide data linkage in New South Wales (NSW), Australia, population 7.8 million. PPH rates in 178 009 people using community MH services in 2016–2017 were compared to population rates. Primary outcomes were crude and age- and disadvantage-standardised annual PPH episode rate (episodes per 100 000 population), PPH day rate (hospital days per 100 000) and adjusted incidence rate ratios (AIRR). Results MH service users had higher rates of PPH admission (AIRR 3.6, 95% CI 3.5–3.6) and a larger number of hospital days (AIRR 5.2, 95% CI 5.2–5.3) than other NSW residents due to increased likelihood of admission, more admissions per person and longer length of stay. Increases were greatest for vaccine-preventable conditions (AIRR 4.7, 95% CI 4.5–5.0), and chronic conditions (AIRR 3.7, 95% CI 3.6–3.7). The highest number of admissions and relative risks were for respiratory and metabolic conditions, including chronic obstructive airways disease (AIRR 5.8, 95% CI 5.5–6.0) and diabetic complications (AIRR 5.4, 95% CI 5.1–5.8). One-quarter of excess potentially preventable bed days in MH service users were due to vaccine-related conditions, including vaccine-preventable respiratory illness. Age-related increases in risk occurred earlier in MH service users, particularly for chronic and vaccine-preventable conditions. PPH rates in MH service users aged 20–29 were similar to population rates of people aged 60 and over. These substantial differences were not explained by socio-economic disadvantage. Conclusions PPHs for physical health conditions are substantially increased in people with MH conditions. Short term (12-month) PPH rates may be a useful lead indicator of increased physical morbidity and less accessible, integrated or effective health care. High hospitalisation rates for vaccine-preventable respiratory infections and hepatitis underline the importance of vaccination in MH service users and suggests potential benefits of prioritising this group for COVID-19 vaccination.

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“…These unaccounted patient risk factors are known to be associated with health outcomes and are largely outside of physicians' control. [9][10][11][12][13][14][15][16] In the presence of inadequate risk adjustment, the ACSC hospitalization measures could lead to inappropriate penalties for outpatient providers, such as safety-net clinics, that serve a high proportion of individuals with social, cognitive, and functional needs. 17,18 Penalties to such providers, often operating on already-thin margins, could be harmful.…”

Section: Introductionmentioning

confidence: 99%

Association of Patient Social, Cognitive, and Functional Risk Factors with Preventable Hospitalizations: Implications for Physician Value-Based Payment

et al. 2019

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BACKGROUND: Ambulatory care-sensitive condition (ACSC) hospitalizations are used to evaluate physicians' performance in Medicare value-based payment programs. However, these measures may disadvantage physicians caring for vulnerable populations because they omit social, cognitive, and functional factors that may be important determinants of hospitalization. OBJECTIVE: To determine whether social, cognitive, and functional risk factors are associated with ACSC hospitalization rates and whether adjusting for them changes outpatient safety-net providers' performance. DESIGN: Using data from the Medicare Current Beneficiary Survey, we conducted patient-level multivariable regression to estimate the association (as incidence rate ratios (IRRs)) between patient-reported social, cognitive, and functional risk factors and ACSC hospitalizations. We compared outpatient safety-net and non-safety-net providers' performance after adjusting for clinical comorbidities alone and after additional adjustment for social, cognitive, and functional factors captured in survey data. SETTING: Safety-net and non-safety-net clinics. PARTICIPANTS: Community-dwelling Medicare beneficiaries contributing 38,616 person-years from 2006 to 2013.

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Potentially Preventable Medical Hospitalizations Among Maryland Residents With Mental Illness, 2005–2010

Cited by 11 publications

References 12 publications

Evaluating the Impact of Integrated Care on Service Utilization in Serious Mental Illness

Evaluating the Impact of Integrated Care on Service Utilization in Serious Mental Illness

Potentially preventable hospitalisations for physical health conditions in community mental health service users: a population-wide linkage study

Association of Patient Social, Cognitive, and Functional Risk Factors with Preventable Hospitalizations: Implications for Physician Value-Based Payment

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