Category: Health Care System / Public Policy
Keywords: Diversity | Adolescents | Health Care System
Presentation Type: Symposium
Objective: Outpatient follow-up after acute mental health treatment is an important indicator of health care quality. This is particularly true for children and adolescents, who are often in the early stages of illness, and engaging with the mental health care system for the first time. Racial/ethnic differences in post-acute outcomes among this population are understudied. This study assesses the quality of outpatient treatment episodes following emergency department or inpatient psychiatric treatment among black, white, and Hispanic children and adolescents in the United States.
Methods: In preliminary analyses, data from multiple two-year panels from the Medical Expenditure Panel Survey were used to identify youth aged 5-17 between 1996 and 2009 with any emergency department or inpatient psychiatric treatment (N=261). Logistic regression models estimated predictors of any outpatient follow-up or the beginning of adequate outpatient follow-up within 7 or 30 days following discharge. Estimates were adjusted for clinical need variables but not for socioeconomic characteristics, consistent with the Institute of Medicine definition of health care disparities. Additional respondent data from 2010 to 2014 will be added.
Results: Rates of follow-up within 7 days of inpatient discharge were 25%, 7%, and 33% for whites, blacks and Hispanics, respectively. Rates of adequate treatment after discharge were 50%, 19%, and 48% for whites, blacks, and Latinos, respectively. In general, outpatient follow-up was more likely following inpatient psychiatric care than emergency department encounters. After adjustment for need and socioeconomic status, black youth were less likely than white youth to receive any treatment or to begin adequate follow-up within 30 days of inpatient discharge.
Conclusions: Over the last two decades, the majority of youth receiving acute psychiatric care, and particularly black youth, have not received adequate outpatient follow-up. Interventions that effectively and appropriately link black youth to outpatient follow-up care are needed to reduce racial-ethnic disparities in outpatient mental health treatment following acute treatment.
Saturday, November 18
8:30 AM – 10:00 AM
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