Published in:
01-04-2013
Hospital Readmission Among Medicaid Patients with an Index Hospitalization for Mental and/or Substance Use Disorder
Authors:
Tami Mark, PhD, MBA, Karen Smoyer Tomic, PhD, Niranjana Kowlessar, PhD, Bong Chul Chu, PhD, Rita Vandivort-Warren, MSW, Shelagh Smith, MPH, CHES
Published in:
The Journal of Behavioral Health Services & Research
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Issue 2/2013
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Abstract
Hospital readmission rates are increasingly used as a performance indicator. Whether they are a valid, reliable, and actionable measure for behavioral health is unknown. Using the MarketScan Multistate Medicaid Claims Database, this study examined hospital- and patient-level predictors of behavioral health readmission rates. Among hospitals with at least 25 annual admissions, the median behavioral health readmission rate was 11% (10th percentile, 3%; 90th percentile, 18%). Increased follow-up at community mental health centers was associated with lower probabilities of readmission, although follow-up with other types of providers was not significantly associated with hospital readmissions. Hospital average length of stay was positively associated with lower readmission rates; however, the effect size was small. Patients with a prior inpatient stay, a substance use disorder, psychotic illness, and medical comorbidities were more likely to be readmitted. Additional research is needed to further understand how the provision of inpatient services and post-discharge follow-up influence readmissions.