Impact of a mental health based primary care program on emergency department visits and inpatient stays

General Hospital Psychiatry
Joshua BreslauHao Yu

Abstract

Integrating primary care services into specialty mental health clinics has been proposed as a method for improving health care utilization for medical conditions by adults with serious mental illness. This paper examines the impact of a mental health based primary care program on emergency department (ED) visits and hospitalizations. The program was implemented in seven New York City outpatient mental health clinics in two waves. Medicaid claims were used to identify patients treated in intervention clinics and a control group of patients treated in otherwise similar clinics in New York City. Impacts of the program were estimated using propensity score adjusted difference-in-differences models on a longitudinally followed cohort. Hospital stays for medical conditions increased significantly in intervention clinics relative to control clinics in both waves (ORs = 1.21 (Wave 1) and 1.33 (Wave 2)). ED visits for behavioral health conditions decreased significantly relative to controls in Wave 1 (OR = 0.89), but not in Wave 2. No other significant differences in utilization trends between the intervention and control clinics were found. Introducing primary care services into mental health clinics may increase utilization of inpatie...Continue Reading

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Mar 2, 2019·International Review of Psychiatry·Karly A MurphyEmma E McGinty
Sep 11, 2019·Psychiatric Services : a Journal of the American Psychiatric Association·Karen L FortunaSarah I Pratt
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Oct 10, 2020·Pediatric Annals·Courtney Romba, Rachel Ballard
Apr 21, 2021·Health Services Research·Eric Y FrimpongMarleen Radigan

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