Potentially Preventable Medical Hospitalizations and Emergency Department Visits by the Behavioral Health Population

Schmidt, Eric; Behar, Simone; Barrera, Alinne Z.; Cordova, Matthew J.; Beckum, Leonard C.

doi:10.1007/s11414-017-9570-y

Cited by 13 publications

(9 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Taken together, these results are consistent with prior literature showing that approximately 30% to 50% of these patients with frequent ED utilization have a mental health or substance use disorder. 11, 46-49…”

Section: Discussionmentioning

confidence: 99%

Computer adaptive testing to assess impairing behavioral health problems in emergency department patients

O’Reilly

Dalal

Maag

et al. 2022

Preprint

View full text Add to dashboard Cite

Study Objective: To assess the prevalence of several impairing behavioral health domains in stable patients presenting to the emergency department (ED) through the use of computer adaptive testing and the association among the domains, standard assessments, and ED utilization. Methods: This was a single-center observational study of 828 randomly selected adult patients presenting to the ED from May 2019 to March 2020. The main outcomes of interest were the self-administered, validated computer adaptive assessments of suicidality, depression, anxiety, PTSD, and substance abuse using computer adaptive testing, the CAT-MHTM. We estimated the association among the CAT-MHTM subscales, standard assessments, and the number of ED visits in the year prior and 30 days after enrollment. Results: The proportion of those who scored above the threshold of low/mild risk were: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). While the CAT-MHTM subscales were highly correlated with other self-report assessments, they were not highly associated with standard ED assessments of suicidality. When examining associations with ED use, for example, individuals who had two or more ED visits in the prior year had 51% increased odds of being in the intermediate-high suicide risk category (95% Confidence Interval [CI], 1.03-2.23) compared to those with zero prior ED visits. Conclusion: The CAT-MHTM can document the high prevalence of mental health conditions in the ED, which were missed by standard ED practices. Mental health problems are associated with ED utilization in a population of patients presenting largely for somatic complaints.

show abstract

Section: Discussionmentioning

confidence: 99%

Computer adaptive testing to assess impairing behavioral health problems in emergency department patients

O’Reilly

Dalal

Maag

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…Schmidt et al. (2018) [ 11 ] identified 9.8% of 1.5 million ED visits and 33.6% of 1 million hospitalizations as psychiatric PPRs in California. Moreover, psychiatric PPRs cost NYS Medicaid more than $200 million total, averaging over $13,500 per patient [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of behavioral health unit readmission within 30 days of discharge: A retrospective study

Everett

Krasinski²,

Druyor³

et al. 2022

Heliyon

View full text Add to dashboard Cite

Potentially Preventable Medical Hospitalizations and Emergency Department Visits by the Behavioral Health Population

Cited by 13 publications

References 39 publications

Computer adaptive testing to assess impairing behavioral health problems in emergency department patients

Computer adaptive testing to assess impairing behavioral health problems in emergency department patients

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

Predictors of behavioral health unit readmission within 30 days of discharge: A retrospective study

Contact Info

Product

Resources

About