Variations in Medicaid Mental Health Service Use and Cost for Children

Howell, Embry; Teich, Judith L.

doi:10.1007/s10488-008-0163-1

Cited by 68 publications

(17 citation statements)

References 11 publications

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“…Differences in findings across states, however, require interpretation in the context of state policies and service systems (Hanson and Huskamp 2001;Howell and Teich 2008). States vary widely in the benefit limits and administration processes associated with Medicaid mental health services (Howell and Teich 2008). Thus, our analyses of claims alone cannot explain the cause of state variation but instead should be a starting point for further state-based research.…”

Section: Discussionmentioning

confidence: 97%

“…Finally, average Medicaid expenditures per beneficiary were highest among PRTFs in each state, which may be indicative of the resources allocated to PRTFs and the significant needs of the populations PRTFs serve. Differences in findings across states, however, require interpretation in the context of state policies and service systems (Hanson and Huskamp 2001;Howell and Teich 2008). States vary widely in the benefit limits and administration processes associated with Medicaid mental health services (Howell and Teich 2008).…”

Section: Discussionmentioning

confidence: 99%

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State Variation in Out-of-Home Medicaid Mental Health Services for Children and Youth: An Examination of Residential Treatment and Inpatient Hospital Services

Brown

Natzke

Ireys

et al. 2009

Adm Policy Ment Health

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This research investigated state variation in the use of out-of-home mental health services among children and youth enrolled in Medicaid during 2003. Medicaid claims from three states were used to describe the demographic and diagnostic characteristics of children and youth under age 22 who received mental health services in general hospitals, psychiatric hospitals, psychiatric residential treatment facilities, and other residential treatment settings and to examine their lengths of stay, repeat stays, and expenditures. Depending on the state, 6-13% of children and youth with a mental health diagnosis received out-of-home services during the year; 37-58% of these children and youth had more than one out-of-home stay. Out-of-home mental health services accounted for 21-75% of Medicaid mental health expenditures for children and youth, depending on the state. States varied considerably in lengths of stay and per beneficiary expenditures for out-of-home care. Although some similarities in out-of-home care were found across states, substantial state variation in out-of-home care warrants further research in the context of state service systems and Medicaid policies.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

State Variation in Out-of-Home Medicaid Mental Health Services for Children and Youth: An Examination of Residential Treatment and Inpatient Hospital Services

Brown

Natzke

Ireys

et al. 2009

Adm Policy Ment Health

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“…There is an increasing number of young children referred to mental health clinics (Howell & Teich, 2008). Among these children, attention deficit and disruptive behavior problems are the most common reasons for referral (Wilens et al, 2002).…”

mentioning

confidence: 99%

Clinical Usefulness of Observational Assessment in the Diagnosis of DBD and ADHD in Preschoolers

Bunte

Laschen

Schoemaker

et al. 2013

Journal of Clinical Child & Adolescent Psychology

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The aim of the present study was to investigate the clinical usefulness of an observational tool--the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS)--in the diagnosis of disruptive behavior disorders (DBD) and attention deficit/hyperactivity disorder (ADHD) in preschoolers. We hypothesized that the DB-DOS may help support the presumption of a diagnosis generated by the information from parents and teachers (or other caregivers). Participants were referred preschool children with externalizing behavioral problems (N = 193; 83% male) and typically developing children (N = 58; 71% male). In view of the clinical validity study each child was given a diagnosis of either DBD (N = 40), or ADHD (N = 54) or comorbid (DBD + ADHD; N = 66) based on best-estimate diagnosis. The DB-DOS demonstrated good interrater and test-retest reliability for DBD and ADHD symptom scores. Confirmatory factor analysis demonstrated an excellent fit of the DB-DOS multidomain model of DBD symptom scores and a satisfactory fit of ADHD symptom scores. The DB-DOS demonstrated good convergent validity, moderate divergent validity, and good clinical validity on a diagnostic group level for DBD and ADHD symptom scores. The Receiver Operating Characteristic curve analyses revealed that for DBD the sensitivity and specificity are moderate and for ADHD good to excellent. The presumption of a diagnosis based on information from parents, teachers, and cognitive assessment was supported by the DB-DOS in 60% for DBD and 75% for ADHD. The DB-DOS can be used to help support a presumption of a DBD and/or ADHD diagnosis in preschool children.

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“…Two recent trends in the U.S. suggest that there is a need to examine agreement between different adult informants on symptoms in younger children. First, there are increasing numbers of young children presenting to mental health clinics (Howell and Teich 2008;Ringel and Sturm 2001), and disruptive behavior problems are the most common reason for referral of these children (Campbell 1995). Recent data indicate that "Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) symptoms and diagnostic criteria identify groups of impaired preschoolers with clinically significant behavior problems" (Egger and Angold 2006, p. 324), and that the structure of psychopathology in preschoolers is similar that that for school-age children according to the DSM-IV (Sterba et al 2007;Strickland et al 2011).…”

mentioning

confidence: 99%

Mother-Teacher Agreement on Preschoolers’ Symptoms of ODD and CD: Does Context matter?

Strickland

Hopkins

Keenan

2012

J Abnorm Child Psychol

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The aims of this study were to examine mother-teacher agreement on oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms and diagnoses in preschool children; to determine if context is a source of disagreement; and to explore if sex, referral status, and age moderated agreement rates. Participants included 158 male and 139 female 3- to 5-year old preschool children, their mothers, and teachers. A structured interview, the Kiddie-Disruptive Behavior Disorder Schedule was used for maternal report and teachers completed the Early Childhood Inventory. Results indicated that mothers reported more symptoms and diagnoses of ODD and CD than teachers, and mother-teacher agreement on both ODD and CD symptoms and diagnoses was low. Level of mother-teacher agreement increased when reporting on behavior in the same context; however, the rates remain modest. Referral status increased the likelihood of mother and teacher agreement on several ODD and CD symptoms, as well as ODD and CD diagnosis. These data suggest that context plays a role in mother-teacher agreement in the assessment of young children's ODD and CD symptoms.

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Variations in Medicaid Mental Health Service Use and Cost for Children

Cited by 68 publications

References 11 publications

State Variation in Out-of-Home Medicaid Mental Health Services for Children and Youth: An Examination of Residential Treatment and Inpatient Hospital Services

State Variation in Out-of-Home Medicaid Mental Health Services for Children and Youth: An Examination of Residential Treatment and Inpatient Hospital Services

Clinical Usefulness of Observational Assessment in the Diagnosis of DBD and ADHD in Preschoolers

Mother-Teacher Agreement on Preschoolers’ Symptoms of ODD and CD: Does Context matter?

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