Substantial hospital level variation in all-cause readmission rates among medicare beneficiaries with serious mental illness

Germack, Hayley D.; Bizhanova, Zhadyra; Roberts, Eric T.

doi:10.1016/j.hjdsi.2020.100453

“…Inclusion of dually eligible Medicare enrollees is consistent with earlier literature. 4 , 5 , 26 , 27 Fourth, among the subgroup of Medicare beneficiaries not dually eligible for Medicaid, we found an association between greater telemental health service use and greater medication adherence. What underlies that association in just this subgroup of patients is unclear and merits further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Before the COVID-19 pandemic, there was rapid growth in the number of live video-based telemental health service visits in nonmetropolitan areas. 4 , 5 Since the start of the COVID-19 pandemic, that growth has accelerated, and in some analyses most visits with behavioral health care professionals are via telemedicine. 6 Although numerous randomized clinical trials have demonstrated that live-video telemental health and in-person visits are comparable in treating patients with mental illness, 7 , 8 , 9 it has never been demonstrated that greater use of telemental health visits outside of clinical trials improves care quality by expanding access to needed care.…”

Section: Introductionmentioning

confidence: 99%

“…Telemental health interaction is one potential solution for these access barriers. Before the COVID-19 pandemic, there was rapid growth in the number of live video-based telemental health service visits in nonmetropolitan areas . Since the start of the COVID-19 pandemic, that growth has accelerated, and in some analyses most visits with behavioral health care professionals are via telemedicine .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association Between Telemedicine Use in Nonmetropolitan Counties and Quality of Care Received by Medicare Beneficiaries With Serious Mental Illness

Wang

¹

,

Huskamp

²

,

Rose

³

et al. 2022

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“…However, some studies have found relevance that can imply influencing factors at the hospital level and mental health services use. For instance, Germack, Bizhanova, and Roberts conducted a study with substantial hospital-level variation in remission rates among severe mental illness patients [ 26 ]. Another study based on patient perception also mentioned hospital levels and differences in the quality of services [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of continuing mental health service use among older persons diagnosed with depressive disorders in general hospitals: latent class analysis and GEE

Mulalint

¹

,

Seeherunwong

²

,

Wanitkun

³

et al. 2022

BMC Health Serv Res

2

0

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Background Prevalence of depression in older persons was a leading cause of disability. This group has the lowest access to service and retention in care compared to other age groups. This study aimed to explore continuing mental health service use and examined the predictive power of the mental health service delivery system and individual factors on mental health service use among older persons diagnosed with depressive disorders. Methods We employed an analytic cross-sectional study design of individual and organizational variables in 12 general hospitals selected using multi-stratified sampling. There were 3 clusters comprising community hospitals, advanced and standard hospitals, and university hospitals. Participants in each group were 150 persons selected by purposive sampling. We included older persons with a first or recurring diagnosis of a depressive disorder in the last 6 to 12 months of the data collection date. Data at the individual level included socio-demographic characteristics, Charlson Comorbidity Index, Attitude toward Depression and its treatment, and perceived social support. Data at the organizational level had hospital level, nurse competency, nurse-patient ratio, and appointment reminders. Descriptive statistics, Pearson chi-square test, latent class analysis (LCA), and marginal logistic regression model using generalized estimating equation (GEE) were used to analyze the data. Results The continuing mental health service use among older persons diagnosed with depressive disorders was 54%. The latent class analysis of four variables in the mental health services delivery organization yielded distinct and interpretable findings in two groups: high and low resource organization. The marginal logistic multivariable regression model using GEE found that organizational group and attitude toward depression and its treatment were significantly associated with mental health service use (p-value = 0.046; p-value = 0.003). Conclusions The findings suggest that improving continuing mental health services use in older persons diagnosed with depressive disorders should emphasize specialty resources of the mental health services delivery system and attitude toward depression and its treatment.

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“…However, some studies have found relevance that can imply in uencing factors at the hospital level and mental health services use. For instance, Germack, Bizhanova, and Roberts conducted a study with substantial hospital-level variation in remission rates among serious mental illness patients [25]. Another study based on patient perception also mentioned hospital levels and differences in the quality of services [26].…”

Section: Introductionmentioning

confidence: 99%

Determinants of continuing mental health service use among older persons diagnosed with depressive disorders in general hospitals: latent class analysis and GEE

Mulalint

¹

,

Seeherunwong

²

,

Wanitkun

³

et al. 2022

Preprint

0

View full text Add to dashboard Cite

Background Prevalence of depression in older persons was a leading cause of disability. This group has the lowest access to service and retention in care compared to other age groups. This study aimed to explore continuing mental health service use and examined the predictive power of the mental health service delivery system and individual factors on mental health service use among older persons diagnosed with depressive disorders. Methods We employed an analytic cross-sectional study design of individual and organizational variables in 12 general hospitals selected using multi-stratified sampling. There were 3 clusters comprising community hospitals, advanced and standard hospitals, and university hospitals. Participants in each group were 150 persons selected by purposive sampling. We included older persons with a first or recurring diagnosis of a depressive disorder in the last 6 to 12 months of the data collection date. Data at the individual level included socio-demographic characteristics, Charlson Comorbidity Index, Attitude toward Depression and its treatment, and perceived social support. Data at the organizational level had hospital level, nurse competency, nurse-patient ratio, and appointment reminders. Descriptive statistics, Pearson chi-square test, latent class analysis (LCA), and marginal logistic regression model using generalized estimating equation (GEE) were used to analyze the data. Results The continuing mental health service use among older persons diagnosed with depressive disorders was 54%. The latent class analysis of four variables in the mental health services delivery organization yielded distinct and interpretable findings in two groups: high and low resource organization. The marginal logistic multivariable regression model using GEE found that organizational group and attitude toward depression and its treatment were significantly associated with mental health service use (p-value = 0.046; p-value = 0.003). Conclusions The findings suggest that improving continuing mental health services use in older persons diagnosed with depressive disorders should emphasize specialty resources of the mental health services delivery system and attitude toward depression and its treatment.

show abstract

Substantial hospital level variation in all-cause readmission rates among medicare beneficiaries with serious mental illness

Cited by 6 publications

References 26 publications

Association Between Telemedicine Use in Nonmetropolitan Counties and Quality of Care Received by Medicare Beneficiaries With Serious Mental Illness

Association Between Telemedicine Use in Nonmetropolitan Counties and Quality of Care Received by Medicare Beneficiaries With Serious Mental Illness

Determinants of continuing mental health service use among older persons diagnosed with depressive disorders in general hospitals: latent class analysis and GEE

Determinants of continuing mental health service use among older persons diagnosed with depressive disorders in general hospitals: latent class analysis and GEE

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