Jie Chen1, Priscilla Novak1, Deanna Barath1, Howard Goldman2, Karoline Mortensen3. 1. Department of Health Services Administration, School of Public Health, University of Maryland, College Park. 2. Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, MD. 3. Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables, FL.
Abstract
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.
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.
Authors: Marc Kowalkowski; Shih-Hsiung Chou; Andrew McWilliams; Cathryn Lashley; Stephanie Murphy; Whitney Rossman; Alfred Papali; Alan Heffner; Mark Russo; Larry Burke; Michael Gibbs; Stephanie P Taylor Journal: Trials Date: 2019-11-29 Impact factor: 2.279
Authors: Jonathan Purtle; Katherine L Nelson; Nathaniel Z Counts; Michael Yudell Journal: Annu Rev Public Health Date: 2020-01-06 Impact factor: 21.981