Megan Moore1, Nathalia Jimenez, Janessa M Graves, Tessa Rue, Jesse R Fann, Frederick P Rivara, Monica S Vavilala. 1. School of Social Work (Dr Moore), Harborview Injury Prevention and Research Center (Drs Moore, Jimenez, Rivara, and Vavilala), Institute of Translational Health Sciences (Dr Rue), and Departments of Anesthesiology and Pain Medicine (Drs Jimenez and Vavilala), Psychiatry and Behavioral Health (Dr Fann), and Pediatrics (Dr Rivara), University of Washington, Seattle; Seattle Children's Hospital, Seattle, Washington (Drs Jimenez and Rivara); and Washington State University College of Nursing, Spokane (Dr Graves).
Abstract
OBJECTIVE: To examine racial differences in mental health service utilization after hospitalization for traumatic brain injury (TBI) among children with Medicaid insurance. DESIGN AND MAIN MEASURES: Retrospective analysis of the MarketScan Multi-State Medicaid database from 2007 to 2012 was performed. Outpatient mental health service utilization (psychiatric and psychological individual and group services) was compared at TBI hospitalization, from discharge to 3 months and from 4 to 12 months after discharge, between children of non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, and "Other" racial groups. Multivariable mixed-effects Poisson regression models with robust standard errors were utilized. RESULTS: A total of 5674 children (aged <21 years) were included in the study. There were no differences by race/ethnicity in mental health service utilization during hospitalization. At 3 months postdischarge, NHB children and children in the "Other" racial category were significantly less likely to receive outpatient mental health services than NHW children (NHB relative risk [RR] = 0.84; 95% confidence interval [CI], 0.72-0.98; Other RR = 0.72; 95% CI, 0.57-0.90). At 12 months, all racial minority children were significantly less likely to receive outpatient mental health services than NHW children (NHB RR = 0.84; 95% CI, 0.75-0.94; Hispanic RR = 0.72; 95% CI, 0.55-0.94; Other RR = 0.71; 95% CI, 0.60-0.84). CONCLUSIONS: Racial disparities in utilization of outpatient mental health services exist for minority children hospitalized for TBI and insured by Medicaid. Future research should focus on improving transitions of care from inpatient to outpatient services for these children.
OBJECTIVE: To examine racial differences in mental health service utilization after hospitalization for traumatic brain injury (TBI) among children with Medicaid insurance. DESIGN AND MAIN MEASURES: Retrospective analysis of the MarketScan Multi-State Medicaid database from 2007 to 2012 was performed. Outpatient mental health service utilization (psychiatric and psychological individual and group services) was compared at TBI hospitalization, from discharge to 3 months and from 4 to 12 months after discharge, between children of non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, and "Other" racial groups. Multivariable mixed-effects Poisson regression models with robust standard errors were utilized. RESULTS: A total of 5674 children (aged <21 years) were included in the study. There were no differences by race/ethnicity in mental health service utilization during hospitalization. At 3 months postdischarge, NHB children and children in the "Other" racial category were significantly less likely to receive outpatient mental health services than NHW children (NHB relative risk [RR] = 0.84; 95% confidence interval [CI], 0.72-0.98; Other RR = 0.72; 95% CI, 0.57-0.90). At 12 months, all racial minority children were significantly less likely to receive outpatient mental health services than NHW children (NHB RR = 0.84; 95% CI, 0.75-0.94; Hispanic RR = 0.72; 95% CI, 0.55-0.94; Other RR = 0.71; 95% CI, 0.60-0.84). CONCLUSIONS: Racial disparities in utilization of outpatient mental health services exist for minority children hospitalized for TBI and insured by Medicaid. Future research should focus on improving transitions of care from inpatient to outpatient services for these children.
Authors: Stephen S O'Connor; Douglas F Zatzick; Jin Wang; Nancy Temkin; Thomas D Koepsell; Kenneth M Jaffe; Dennis Durbin; Monica S Vavilala; Andrea Dorsch; Frederick P Rivara Journal: J Trauma Stress Date: 2012-06
Authors: Nathalia Jimenez; Beth E Ebel; Jin Wang; Thomas D Koepsell; Kenneth M Jaffe; Andrea Dorsch; Dennis Durbin; Monica S Vavilala; Nancy Temkin; Frederick P Rivara Journal: Pediatrics Date: 2013-05-06 Impact factor: 7.124
Authors: Nathalia Jimenez; Marisa Osorio; Jessica L Ramos; Susan Apkon; Beth E Ebel; Frederick P Rivara Journal: Arch Phys Med Rehabil Date: 2015-03-04 Impact factor: 3.966
Authors: Megan Moore; Nathalia Jimenez; Ali Rowhani-Rahbar; Margaret Willis; Kate Baron; Jessica Giordano; Deborah Crawley; Frederick P Rivara; Kenneth M Jaffe; Beth E Ebel Journal: Am J Phys Med Rehabil Date: 2016-03 Impact factor: 2.159
Authors: Allison P Fisher; Jessica M Aguilar; Nanhua Zhang; Keith Owen Yeates; H Gerry Taylor; Brad G Kurowski; Megan E Narad; Shari L Wade Journal: Res Child Adolesc Psychopathol Date: 2021-01-06