Child Sociodemographic Characteristics and Common Psychiatric Diagnoses in Medicaid Encounter Data: Are they Valid?

Abstract

This study describes the rate that Medicaid encounter data on gender, race/ethnicity, and diagnosis matched information in the medical record, among a statewide sample of Medicaid children who received ongoing care for attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), and major depression (MD) in outpatient specialty mental health clinics in 1998-1999. The match rate for gender was 99%; and for race/ethnicity it was 71.8%, 90.5%, and 89.7% for Caucasian, African American, and Hispanic children, respectively. Misidentified Caucasian children were more likely to be recorded as African American or Hispanic than misidentified minority children to be recorded as Caucasian. Diagnosis match rates were high (ADHD: 98%, CD: 89%, MD: 89%). If the California Department of Mental Health relied solely on Medicaid encounter data, misclassification of African American or Hispanic children as Caucasian could produce an underestimate of their service use.

In Utero Exposure to Ischemic-Hypoxic Conditions and Attention-Deficit/Hyperactivity Disorder

“…Similar to a previous report, 59 this approach increased the specificity of case ascertainment. Moreover, KPSC has stringent criteria that must be met for the diagnosis of ADHD: (1) every child has a standardized form, "The Child Behavior Checklist," that parents and teachers fill out to describe the child' s behavioral and emotional problems and (2) 61,62 Although one may argue that the diagnosis of ADHD by health care professionals with appropriate expertise to diagnose and treat the condition is a reflection of validity, here we would also like to underline that we have not compared whether the diagnostic validity has increased by the KPSC approach or whether it is any better than a diagnosis made by parent and teacher reports with rapid pediatrician assessment.…”

How Many Nursing Home Residents Live With a Mental Illness?

“…Inpatient claims were included if they occurred after the date of the long-term-care claim, and outpatient claims were included if they occurred in the same month as the long-term-care claim. Studies that examined the reliability of Medicaid claims data for use in research on psychiatric disorders have found the primary and secondary diagnosis variables to be reliable (10,11).…”

Psychiatric Diagnosis and Antiretroviral Adherence Among Adolescent Medicaid Beneficiaries Diagnosed With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

“…We lacked structured interview data for psychiatric diagnoses, for example. However, diagnostic concordance for psychiatric diagnoses between medical records and Medicaid claims is often high (Walkup et al, 2000), including recent reports of agreement between 89% to 98% for common psychiatric conditions in childhood (Knapp et al, 2006). Support for pharmacy refill persistence as an ART adherence measure is generally strong, with correlations found with various biological measures (e.g., Grossberg et al, 2004), including a study of younger patients (Watson and Farley, 1999).…”