Skip to main content
Erschienen in: The Journal of Behavioral Health Services & Research 1/2017

06.06.2016

Risk of Early Rehospitalization for Non-Behavioral Health Conditions Among Adult Medicaid Beneficiaries with Severe Mental Illness or Substance Use Disorders

verfasst von: Marion A. Becker, PhD, Timothy L. Boaz, PhD, Ross Andel, PhD, Samantha Hafner, MSW

Erschienen in: The Journal of Behavioral Health Services & Research | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

The goal was to examine risk factors and expenditures for early rehospitalization (within 30 days of discharge) for non-behavioral health conditions among Medicaid-enrolled Floridians over 8 years. There were 1,689,797 hospitalization episodes with 19% (N = 314,742) resulting in early rehospitalization. Total gross charges for early rehospitalization were over 13 billion dollars. In Cox proportional hazards regression adjusted for demographic and health covariates, drug use disorder was associated with 50% increased risk of early rehospitalization. Having major depressive disorder increased risk by 17%; psychotic disorder, bipolar disorder, and alcohol use disorder increased risk of early rehospitalization slightly by 10, 6, and 6% respectively. The effect of dementia on risk was minimal at 2%. Risk of early rehospitalization decreased by 3.5% per year over the 8 years of the study. Attention to mental health problems, especially drug use disorder, may help further reduce rates of early readmission for non-behavioral health conditions.
Literatur
1.
Zurück zum Zitat Konetzka RT, Spector W, Limcangco MR. Reducing hospitalizations from long-term care settings. Medical Care Research & Review 2008; 65(1):40–66.CrossRef Konetzka RT, Spector W, Limcangco MR. Reducing hospitalizations from long-term care settings. Medical Care Research & Review 2008; 65(1):40–66.CrossRef
2.
Zurück zum Zitat Bindman AB, Chattopadhyay A, Auerback GM. Interruptions in Medicaid coverage and risk for hospitalization for ambulatory care--sensitive conditions. Annals of Internal Medicine 2008; 149(12): 854–60.CrossRefPubMed Bindman AB, Chattopadhyay A, Auerback GM. Interruptions in Medicaid coverage and risk for hospitalization for ambulatory care--sensitive conditions. Annals of Internal Medicine 2008; 149(12): 854–60.CrossRefPubMed
3.
Zurück zum Zitat Schmutte T, Dunn CL, Sledge WH: Predicting time to readmission in patients with recent histories of recurrent psychiatric hospitalization. Journal of Nervous and Mental Disease 2010; 198(12): 860–863.CrossRefPubMed Schmutte T, Dunn CL, Sledge WH: Predicting time to readmission in patients with recent histories of recurrent psychiatric hospitalization. Journal of Nervous and Mental Disease 2010; 198(12): 860–863.CrossRefPubMed
4.
Zurück zum Zitat Ouslander JG, Berenson RA. Reducing unnecessary hospitalizations of nursing home residents. New England Journal of Medicine 2011; 365(13): 1165–7.CrossRefPubMed Ouslander JG, Berenson RA. Reducing unnecessary hospitalizations of nursing home residents. New England Journal of Medicine 2011; 365(13): 1165–7.CrossRefPubMed
5.
Zurück zum Zitat Durbin J, Lin E, Layne C, Teed M: Is readmission a valid indicator of the quality of inpatient psychiatric care? Journal of Behavioral Health Services and Research 2007; 34(2): 137–150.CrossRefPubMed Durbin J, Lin E, Layne C, Teed M: Is readmission a valid indicator of the quality of inpatient psychiatric care? Journal of Behavioral Health Services and Research 2007; 34(2): 137–150.CrossRefPubMed
6.
Zurück zum Zitat DePalma G, Xu, H Covinsky KE, et al. Hospital readmission among older adults who return home with unmet need for ADL disability. The Gerontologist 2013; 53(3): 545–461.CrossRef DePalma G, Xu, H Covinsky KE, et al. Hospital readmission among older adults who return home with unmet need for ADL disability. The Gerontologist 2013; 53(3): 545–461.CrossRef
7.
Zurück zum Zitat Benbassat J, Taragin M. Hospital readmissions as a measure of quality of health care: advantages and limitations. Archives of Internal Medicine 2000; 160(8): 1074–1081.CrossRefPubMed Benbassat J, Taragin M. Hospital readmissions as a measure of quality of health care: advantages and limitations. Archives of Internal Medicine 2000; 160(8): 1074–1081.CrossRefPubMed
8.
Zurück zum Zitat Feigenbaum P, Neuwirth E, Trowbridge L, et al. Factors contributing to all-cause 30-day readmissions: a structure case series across 18 hospitals. Medical Care 2012; 50(7): 599–605.CrossRefPubMed Feigenbaum P, Neuwirth E, Trowbridge L, et al. Factors contributing to all-cause 30-day readmissions: a structure case series across 18 hospitals. Medical Care 2012; 50(7): 599–605.CrossRefPubMed
9.
Zurück zum Zitat Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine 2009; 360(14): 1418–1428.CrossRefPubMed Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine 2009; 360(14): 1418–1428.CrossRefPubMed
10.
Zurück zum Zitat Askren-Gonzalez A, Frate J. Case management programs for hospital readmission prevention. Professional Case Management 2012; 17(5): 219–226.CrossRefPubMed Askren-Gonzalez A, Frate J. Case management programs for hospital readmission prevention. Professional Case Management 2012; 17(5): 219–226.CrossRefPubMed
11.
Zurück zum Zitat Gu Q, Koneig L, Faerberg J, et al. The Medicare Readmissions Reduction Program: potential unintended consequences for hospitals serving vulnerable populations. Health Services Research 2014; 49(12): 818–837.CrossRefPubMedPubMedCentral Gu Q, Koneig L, Faerberg J, et al. The Medicare Readmissions Reduction Program: potential unintended consequences for hospitals serving vulnerable populations. Health Services Research 2014; 49(12): 818–837.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Hadley J, Steinberg EP, Feder J. Comparison of uninsured and privately insured hospital patients: condition on admission, resource use, and outcome. Journal of the American Medical Association 1991; 265: 374–9.CrossRefPubMed Hadley J, Steinberg EP, Feder J. Comparison of uninsured and privately insured hospital patients: condition on admission, resource use, and outcome. Journal of the American Medical Association 1991; 265: 374–9.CrossRefPubMed
13.
Zurück zum Zitat Weissman JS, Gatsonis C, Epstein AM. Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland. Journal of the American Medical Association 1992; 268(17): 2388–94.CrossRefPubMed Weissman JS, Gatsonis C, Epstein AM. Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland. Journal of the American Medical Association 1992; 268(17): 2388–94.CrossRefPubMed
14.
Zurück zum Zitat Bravo G, Dubois MF, Hebert R, et al. A prospective evaluation of the Charlson Comorbidity Index for use in long-term care patients. Journal of the American Geriatrics Society 2002; 50(4): 740–5.CrossRefPubMed Bravo G, Dubois MF, Hebert R, et al. A prospective evaluation of the Charlson Comorbidity Index for use in long-term care patients. Journal of the American Geriatrics Society 2002; 50(4): 740–5.CrossRefPubMed
15.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases 1987; 40(5): 373–383.CrossRefPubMed Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases 1987; 40(5): 373–383.CrossRefPubMed
16.
Zurück zum Zitat Quan H, Parsons GA, Ghali WA. Validity of information on comorbidity derived from ICD-9-CCM administrative data. Medical Care 2002; 40(8): 675–85.CrossRefPubMed Quan H, Parsons GA, Ghali WA. Validity of information on comorbidity derived from ICD-9-CCM administrative data. Medical Care 2002; 40(8): 675–85.CrossRefPubMed
17.
Zurück zum Zitat Sledge WH, Dunn CL: Recurrently readmitted inpatient psychiatric patients: characteristics and care. In: Ovsiew F, Munich R, ed. Principles of Inpatient Psychiatry. Baltimore, MD: Lippincott Williams and Wilkins; 2008: 235–250. Sledge WH, Dunn CL: Recurrently readmitted inpatient psychiatric patients: characteristics and care. In: Ovsiew F, Munich R, ed. Principles of Inpatient Psychiatry. Baltimore, MD: Lippincott Williams and Wilkins; 2008: 235–250.
18.
Zurück zum Zitat Sledge WH, Dunn CL, Schmutte T. Surprising predictor of rehospitalization. Psychiatric Services 2008; 59(5): 577.CrossRefPubMed Sledge WH, Dunn CL, Schmutte T. Surprising predictor of rehospitalization. Psychiatric Services 2008; 59(5): 577.CrossRefPubMed
19.
Zurück zum Zitat Strosahl K, Robinson P. The primary care behavioral health model: Applications to prevention, acute care and chronic condition management. In: Kessler R, Stafford D, ed. Collaborative medicine case studies: evidence in practice. New York: Springer; 2008: 85–95.CrossRef Strosahl K, Robinson P. The primary care behavioral health model: Applications to prevention, acute care and chronic condition management. In: Kessler R, Stafford D, ed. Collaborative medicine case studies: evidence in practice. New York: Springer; 2008: 85–95.CrossRef
20.
Zurück zum Zitat Druss BG, Mauer BJ: Health care reform and care at the behavioral health –primary care interface. Psychiatric Services 2010; 61(11): 1087–1092.CrossRefPubMed Druss BG, Mauer BJ: Health care reform and care at the behavioral health –primary care interface. Psychiatric Services 2010; 61(11): 1087–1092.CrossRefPubMed
21.
Zurück zum Zitat Mauer B, Druss B: Mind and body reunited: improving care at the behavioral and primary healthcare interface. Journal of Behavioral Health Services and Research 2010; 37(4): 529–542.CrossRefPubMed Mauer B, Druss B: Mind and body reunited: improving care at the behavioral and primary healthcare interface. Journal of Behavioral Health Services and Research 2010; 37(4): 529–542.CrossRefPubMed
22.
Zurück zum Zitat Epstein R, Alper B, Quill T: Communicating evidence for participatory decision making. Journal of the American Medical Association 2004; 291(19): 2359–2366.CrossRefPubMed Epstein R, Alper B, Quill T: Communicating evidence for participatory decision making. Journal of the American Medical Association 2004; 291(19): 2359–2366.CrossRefPubMed
23.
Zurück zum Zitat Bouis S, Reif S, Whetten K, et al. An integrated, multidimensional treatment model for individuals living with HIV, mental illness, and substance abuse. Health & Social Work 2007; 32(4): 268–278.CrossRef Bouis S, Reif S, Whetten K, et al. An integrated, multidimensional treatment model for individuals living with HIV, mental illness, and substance abuse. Health & Social Work 2007; 32(4): 268–278.CrossRef
Metadaten
Titel
Risk of Early Rehospitalization for Non-Behavioral Health Conditions Among Adult Medicaid Beneficiaries with Severe Mental Illness or Substance Use Disorders
verfasst von
Marion A. Becker, PhD
Timothy L. Boaz, PhD
Ross Andel, PhD
Samantha Hafner, MSW
Publikationsdatum
06.06.2016
Verlag
Springer US
Erschienen in
The Journal of Behavioral Health Services & Research / Ausgabe 1/2017
Print ISSN: 1094-3412
Elektronische ISSN: 2168-6793
DOI
https://doi.org/10.1007/s11414-016-9516-9

Weitere Artikel der Ausgabe 1/2017

The Journal of Behavioral Health Services & Research 1/2017 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.