TY - JOUR
T1 - Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland
AU - Chen, Jie
AU - Novak, Priscilla
AU - Barath, Deanna
AU - Goldman, Howard
AU - Mortensen, Karoline
N1 - Funding Information:
J.C. and H.G. are supported by NIH-National Institute of Mental Health (R21MH106813-01, J.C., PI).
PY - 2018
Y1 - 2018
N2 - Background: Individuals affected with mental health conditions, including mood disorders and substance abuse, are at an increased risk of hospital readmission. Objectives: The objective of this study is to examine whether local health departments' (LHDs) active roles of promoting mental health are associated with reductions in 30-day all-cause readmission rates, a common quality metric. Methods: Using datasets linked from multiple sources, including 2012-2013 State Inpatient Databases for the State of Maryland, the National Association of County and City Health Officials Profiles Survey, the Area Health Resource File, and US Census data, we employed multivariate logistic models to examine whether LHDs' active provision of mental health preventive care, mental health services, and health promotion were associated with the likelihood of having any 30-day all-cause readmission. Results: Multivariate logistic regressions showed that LHDs' provision of mental health preventive care, mental health services, and health promotion were negatively associated with the likelihoods of having any 30-day readmission for adults 18-64 years old (odds ratios=0.71-0.82, P<0.001), and adults 65 and above (odds ratios=0.61-0.63, P<0.001, preventive care and services, respectively). These estimated associations were more prominent among individuals with mental illness and/or substance use disorders, African Americans, Medicare, and Medicaid enrollees. Conclusions: Our results suggest that LHDs in Maryland that engage in mental health prevention, promotion, and coordination activities are associated with benefits for residents and for the health care system at large. Additional research is needed to evaluate LHD activities in other states to determine if these results are generalizable.
AB - Background: Individuals affected with mental health conditions, including mood disorders and substance abuse, are at an increased risk of hospital readmission. Objectives: The objective of this study is to examine whether local health departments' (LHDs) active roles of promoting mental health are associated with reductions in 30-day all-cause readmission rates, a common quality metric. Methods: Using datasets linked from multiple sources, including 2012-2013 State Inpatient Databases for the State of Maryland, the National Association of County and City Health Officials Profiles Survey, the Area Health Resource File, and US Census data, we employed multivariate logistic models to examine whether LHDs' active provision of mental health preventive care, mental health services, and health promotion were associated with the likelihood of having any 30-day all-cause readmission. Results: Multivariate logistic regressions showed that LHDs' provision of mental health preventive care, mental health services, and health promotion were negatively associated with the likelihoods of having any 30-day readmission for adults 18-64 years old (odds ratios=0.71-0.82, P<0.001), and adults 65 and above (odds ratios=0.61-0.63, P<0.001, preventive care and services, respectively). These estimated associations were more prominent among individuals with mental illness and/or substance use disorders, African Americans, Medicare, and Medicaid enrollees. Conclusions: Our results suggest that LHDs in Maryland that engage in mental health prevention, promotion, and coordination activities are associated with benefits for residents and for the health care system at large. Additional research is needed to evaluate LHD activities in other states to determine if these results are generalizable.
KW - Mental health
KW - health disparity
KW - local health departments
KW - readmissions
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U2 - 10.1097/MLR.0000000000000850
DO - 10.1097/MLR.0000000000000850
M3 - Article
C2 - 29271821
AN - SCOPUS:85044251213
VL - 56
SP - 153
EP - 161
JO - Medical Care
JF - Medical Care
SN - 0025-7079
IS - 2
ER -