Reducing Preventable Hospitalization and Disparity: Association With Local Health Department Mental Health Promotion Activities

Chen, Jie; Bloodworth, Robin; Novak, Priscilla; Cook, Benjamin Lê; Goldman, Howard H.; Rendall, Michael S.; Thomas, Stephen B.; Reynolds, Charles F.

doi:10.1016/j.amepre.2017.10.011

Cited by 23 publications

(17 citation statements)

References 36 publications

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“…First, despite controlling for a wide range of individual and community characteristics, some confounding variables might be omitted due to data limitations and thus causal conclusions should be interpreted with caution. 54 It is possible that LHDs in areas with fewer SUD-related issues had more resources to be involved with SUD-related policy and prevention; however, prior research has suggested a relationship between LHD interventions and community health outcomes. 58,59 Future studies on LHDs and use of EDs for SUD should also test these associations with longitudinal data sets to ensure temporal associations.…”

Section: Limitationsmentioning

confidence: 99%

“…However, this is a rich dataset and is consistent with other recent work. For example, two recently published studies examined the impact of LHD activities on preventable hospitalizations 54 and avoidable readmissions 55 using years HCUP data years 2012-2013. Since data from 2015/16 is now available for both substance use [5][6][7] and HCUP data, future work should link additional years of data to examine LHD impact over time.…”

Section: Limitationsmentioning

confidence: 99%

“…28 Additionally, research suggests that LHD involvement in mental illness preventive service provision decreases all-cause avoidable rehospitalizations. 29 The literature also provides convincing evidence that when LHDs are integrated with community partners, the incidence rates of chronic and infectious disease are reduced. [30][31] The Public Health 3.0 infrastructure 32 and the 21st Century Cures Act 33 promote the integration of treatment for SUD to be inclusive of individual and organizational factors.…”

Section: Introductionmentioning

confidence: 98%

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Local Health Department Activities to Reduce Emergency Department Visits for Substance Use Disorders

et al. 2019

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The Affordable Care Act (ACA) provides financial incentives to prevent Substance Use Disorders (SUDs). Local health departments (LHDs) can receive funds to establish care teams that partner with primary care providers and health systems. This study estimates the potential effect of LHDs on emergency visits for SUDs, using linked data sets from the Healthcare Cost and Utilization Project (HCUP) Emergency Department Sample for the State of Maryland-2012, the National Association of County and City Health Officials Profiles Survey 2013, and Area Health Resource File 2013 to estimate potential effect of local health department's provision of SUD preventive care and SUD-related policy implementation. LHD involvement in SUD-related policy during the past 2 years and provision of preventive care for behavioral health in the past year significantly reduced the probability of having a SUD-related ED visit by 11% and 6%, respectively, after controlling for individual characteristics (OR=0.89, p<0.001; OR=0.93, p<0.001). After adjusting for the individual and contextual factors, LHD involvement in policy was still associated with 14% reduction in SUD-related ED visits (OR=0.86, p<0.001). Results offer insight on the extent to which the LHD activities can possibly affect SUD-related ED visits and provide a foundation for work to identify effective LHD interventions.

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Section: Limitationsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Local Health Department Activities to Reduce Emergency Department Visits for Substance Use Disorders

et al. 2019

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“…Glanz, Rimer, and Viswanath [21] state that when theory is integrated into health promotion practice, their dynamic interaction helps establish effective and sustainable interventions. In particular, interventions and systems integrating the socio-ecological model for health promotion [22] have been found to improve mental health outcomes (e.g., [23][24][25][26]).…”

Section: Introductionmentioning

confidence: 99%

Exploration of Factors Affecting Post-Secondary Students’ Stress and Academic Success: Application of the Socio-Ecological Model for Health Promotion

Lisnyj

Pearl

McWhirter

et al. 2021

IJERPH

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Overview: There has been an increase in the frequency and severity of stress experienced by Canadian post-secondary students, which has adverse implications on their academic success. This work applied the socio-ecological model for health promotion to explore the contextual factors that influence this relationship at the individual, interpersonal, institutional, community, and public policy levels. Methods: Using a qualitative, phenomenological approach, we conducted 38 semi-structured interviews with undergraduate students and on-campus staff who provide services to this population at a post-secondary institution in Southwestern Ontario, Canada. Thematic analysis inductively identified overarching themes among participants’ perspectives. Results: Several positive and negative factors were identified at each socio-ecological model level, demonstrating the complex interplay of demographic, psychological, emotional, social, physical, and academic factors impacting students’ academic stress. Conclusions: A lack of communication and knowledge seems to underlie many factors, highlighting the need to strengthen communication strategies to promote awareness, accessibility, and availability of services and programs on campus. Results also pointed to focusing on proactive, resilience-focused, upstream mental health promotion efforts at post-secondary institutions to reduce stress and improve academic success. This knowledge can help Canadian campuses better address students’ needs.

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“…[7][8][9][10] The literature also shows that integration of LHDs with community partners is associated with a reduction in the incidence rates of infectious and chronic conditions. [11][12][13] LHDs play critical roles in primary, secondary, and tertiary prevention according to the Essential Public Health Services model developed by the Centers for Disease Control and Prevention. 4 However, research is still needed to increase understanding of how LHDs can be effectively integrated with community partners to improve prevention of and treatment for mental illness.…”

Section: Introductionmentioning

confidence: 99%

Public Health System-Delivered Mental Health Preventive Care Links to Significant Reduction of Health Care Costs

Chen

Novak

Goldman

2018

Population Health Management

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The objective was to estimate the association between health care expenditures and implementation of preventive mental health programs by local health departments (LHDs). Multilevel nationally representative data sets were linked to test the hypothesis that LHDs' provision of preventive mental health programs was associated with cost savings. A generalized linear model with log link and gamma distribution and state-fixed effects was used to estimate the association between LHDs' mental illness prevention services and total health care expenditures per person per year for adults aged 18 years and older. The main outcome measure was the annual total health care expenditure per person. The findings indicated that LHD provision of population-based prevention of mental illness was associated with an $824 reduction (95% confidence interval: -$1,562.94 to -$85.42, P < 0.05) in annual health care costs per person, after controlling for individual, LHD, community, and state characteristics. LHDs can play a critical role in establishing an integrated health care model. Their impact, however, has often been underestimated or neglected. Results showed that a small investment in LHDs may yield substantial cost savings at the societal level. The findings of this research are critical to inform policy decisions for the expansion of the Public Health 3.0 infrastructure.

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Reducing Preventable Hospitalization and Disparity: Association With Local Health Department Mental Health Promotion Activities

Cited by 23 publications

References 36 publications

Local Health Department Activities to Reduce Emergency Department Visits for Substance Use Disorders

Local Health Department Activities to Reduce Emergency Department Visits for Substance Use Disorders

Exploration of Factors Affecting Post-Secondary Students’ Stress and Academic Success: Application of the Socio-Ecological Model for Health Promotion

Public Health System-Delivered Mental Health Preventive Care Links to Significant Reduction of Health Care Costs

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