Retrospective Analysis of Diabetes Care in California Medicaid Patients with Mental Illness

Banta, Jim E.; Morrato, Elaine H.; Lee, Scott W.; Haviland, Mark G.

doi:10.1007/s11606-009-0994-9

Cited by 21 publications

(21 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We already know that mental health status and prescription of antipsychotics reduces likelihood of medical monitoring (such as glycated haemoglobin (HBA1c) testing). 6,73 Primary care physicians often consider such patients to be 'difficult to manage', although many primary care physicians are willing to help with physical healthcare. 74,75 Where primary care physicians lack expertise in mental health they are less likely to offer general care to those with mental illness.…”

Section: Figmentioning

confidence: 99%

Differences in the prescribing of medication for physical disorders in individuals withv.without mental illness: meta-analysis

2012

View full text Add to dashboard Cite

show abstract

Section: Figmentioning

confidence: 99%

Differences in the prescribing of medication for physical disorders in individuals withv.without mental illness: meta-analysis

2012

View full text Add to dashboard Cite

show abstract

“…Two studies of Medicaid enrollees in Massachusetts found that persons with a substance use diagnosis were significantly less likely to receive guideline-concordant care for diabetes (9) and have worse clinical outcomes (10) than other enrollees with diabetes. Two other studies examining subsets of persons with both diabetes and mental illnesses found low rates of performance for diabetes care within a California county (11) and among Maryland Medicaid enrollees. (12)…”

Section: Introductionmentioning

confidence: 99%

Mental Comorbidity and Quality of Diabetes Care Under Medicaid

et al. 2012

View full text Add to dashboard Cite

Background Patients with comorbid medical and mental conditions are at risk for poor quality of care. With the anticipated expansion of Medicaid under health reform, it is particularly important to develop national estimates of the magnitude and correlates of quality deficits related to mental comorbidity among Medicaid enrollees. Methods For all 657,628 fee-for-service Medicaid enrollees with Diabetes during 2003-4, the study compared HEDIS diabetes performance measures (Hemoglobin A1C, eye exams, LDL screening, and treatment for nephropathy), and admissions for ambulatory care-sensitive admissions (ACSCs) between persons with and without mental comorbidity. Nested hierarchical models included individual, county and state-level measures. Results A total of 17.8% of the diabetic sample had a comorbid mental condition. In adjusted models, presence of a mental condition was associated with a 0.83 (0.82 - 0.85) odds of obtaining 2 or more HEDIS indicators, and a 1.32 (1.29-1.34) increase in odds of one or more ACSC hospitalization Among those with diabetes and mental comorbidities, living in a county with a shortage of primary care physicians was associated with reduced performance on HEDIS measures; living in a state with higher Medicaid reimbursement fees and department of mental health expenses per client were associated both with higher quality on HEDIS measures and lower (better) rates of ACSC hospitalizations. Conclusions Among persons with diabetes treated in the Medicaid system, mental comorbidity is an important risk factor for both underuse and overuse of medical care. Modifiable county and state-level factors may mitigate these quality deficits.

show abstract

“…In some study populations with SMI, particularly veteran populations (Desai et al, 2002; Kilbourne et al, 2011), rates of guideline adherence in the population with SMI and general US population were similar. In other study populations, particularly Medicaid beneficiaries, rates were lower (Banta et al, 2009; Blecker et al, 2010; McGinty EE et al, 2012). Our findings suggest that the need for quality improvement likely varies by patient population, insurer, and healthcare delivery system.…”

Section: Discussionmentioning

confidence: 74%

“…As is evident in the range in rates of guideline-concordant care in Table 4, however, other study samples with SMI had considerably lower rates of guideline-concordant care than general US population samples. For example, only 20% of SMI study samples comprised patients with diabetes served by a large urban hospital (Green et al, 2010) and 30% of Medicaid beneficiaries (Banta et al, 2009) with diabetes received eye examinations, compared to consistent national estimates of 50% or greater(Ali et al, 2013a; National Committee on Quality Assurance, 2013; Paksin-Hall et al, 2013). A similar pattern was observed for guideline-based care following treatment of acute myocardial infarction and lipid testing among persons with diabetes.…”

Section: Resultsmentioning

confidence: 99%

Quality of medical care for persons with serious mental illness: A comprehensive review

McGinty

Baller

Azrin

et al. 2015

Schizophrenia Research

139

View full text Add to dashboard Cite

Objectives Prior studies suggest variation in the quality of medical care for somatic conditions such as cardiovascular disease and diabetes provided to persons with SMI, but to date no comprehensive review of the literature has been conducted. The goals of this review were to summarize the prior research on quality of medical care for the United States population with SMI; identify potential sources of variation in quality of care; and identify priorities for future research. Methods Peer-reviewed studies were identified by searching four major research databases and subsequent reference searches of retrieved articles. All studies assessing quality of care for cardiovascular disease, diabetes, dyslipidemia, and HIV/AIDs among persons with schizophrenia and bipolar disorder published between January 2000 and December 2013 were included. Quality indicators and information about the study population and setting were abstracted by two trained reviewers. Results Quality of medical care in the population with SMI varied by study population, time period, and setting. Rates of guideline-concordant care tended to be higher among veterans and lower among Medicaid beneficiaries. In many study samples with SMI, rates of guideline adherence were considerably lower than estimated rates for the general US population. Conclusions Future research should identify and address modifiable provider, insurer, and delivery system factors that contribute to poor quality of medical care among persons with SMI and consider how to best use quality performance measures as part of the larger strategy to improve health for this group.

show abstract

Retrospective Analysis of Diabetes Care in California Medicaid Patients with Mental Illness

Cited by 21 publications

References 35 publications

Differences in the prescribing of medication for physical disorders in individuals withv.without mental illness: meta-analysis

Differences in the prescribing of medication for physical disorders in individuals withv.without mental illness: meta-analysis

Mental Comorbidity and Quality of Diabetes Care Under Medicaid

Quality of medical care for persons with serious mental illness: A comprehensive review

Contact Info

Product

Resources

About