Janet R Cummings1, Xu Ji1, Benjamin G Druss1. 1. Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta (Cummings, Druss); Department of Pediatrics, School of Medicine, Emory University, Atlanta (Ji).
Abstract
OBJECTIVE: Little is known about the role of primary care safety-net clinics, including federally qualified health centers and rural health clinics, in providing mental health services to youths. This study examined correlates and quality of mental health care for youths treated in these settings. METHODS: Medicaid claims data (2008-2010) from nine states were used to identify youths initiating medication for attention-deficit hyperactivity disorder (ADHD) (N=6,433) and youths with an incident depression diagnosis (N=13,209). The authors identified youths who received no ADHD or depression-related visits in a primary care safety-net clinic, some (but less than most) visits in these clinics, and most visits in these clinics. Using bivariate and regression analyses, they examined correlates of mental health treatment in these settings and whether mental health visits in these settings were associated with quality measures. RESULTS: Only 13.5% of the ADHD cohort and 7.2% of the depression cohort sought any ADHD- or depression-related visits in primary care safety-net clinics. Residence in a county with a higher (versus lower) percentage of residents living in an urban area was negatively associated with receiving the majority of mental health visits in these settings (p<0.05). Compared with youths with no visits in these settings, youths who received most of their mental health treatment in these settings received lower-quality care on five of six measures (p<0.01). CONCLUSIONS: As investment in the expansion of mental health services in primary care safety-net clinics grows, future research should assess whether these resources translate into improved mental health care access and quality for Medicaid-enrolled youths.
OBJECTIVE: Little is known about the role of primary care safety-net clinics, including federally qualified health centers and rural health clinics, in providing mental health services to youths. This study examined correlates and quality of mental health care for youths treated in these settings. METHODS: Medicaid claims data (2008-2010) from nine states were used to identify youths initiating medication for attention-deficit hyperactivity disorder (ADHD) (N=6,433) and youths with an incident depression diagnosis (N=13,209). The authors identified youths who received no ADHD or depression-related visits in a primary care safety-net clinic, some (but less than most) visits in these clinics, and most visits in these clinics. Using bivariate and regression analyses, they examined correlates of mental health treatment in these settings and whether mental health visits in these settings were associated with quality measures. RESULTS: Only 13.5% of the ADHD cohort and 7.2% of the depression cohort sought any ADHD- or depression-related visits in primary care safety-net clinics. Residence in a county with a higher (versus lower) percentage of residents living in an urban area was negatively associated with receiving the majority of mental health visits in these settings (p<0.05). Compared with youths with no visits in these settings, youths who received most of their mental health treatment in these settings received lower-quality care on five of six measures (p<0.01). CONCLUSIONS: As investment in the expansion of mental health services in primary care safety-net clinics grows, future research should assess whether these resources translate into improved mental health care access and quality for Medicaid-enrolled youths.
Entities:
Keywords:
Community mental health services; Service delivery systems; children; quality of care
Authors: Mark Wolraich; Lawrence Brown; Ronald T Brown; George DuPaul; Marian Earls; Heidi M Feldman; Theodore G Ganiats; Beth Kaplanek; Bruce Meyer; James Perrin; Karen Pierce; Michael Reiff; Martin T Stein; Susanna Visser Journal: Pediatrics Date: 2011-10-16 Impact factor: 7.124
Authors: Leiyu Shi; Lydie A Lebrun; Jinsheng Zhu; Arthur S Hayashi; Ravi Sharma; Charles A Daly; Alek Sripipatana; Quyen Ngo-Metzger Journal: Health Serv Res Date: 2012-05-17 Impact factor: 3.402
Authors: Boris Birmaher; David Brent; William Bernet; Oscar Bukstein; Heather Walter; R Scott Benson; Allan Chrisman; Tiffany Farchione; Laurence Greenhill; John Hamilton; Helene Keable; Joan Kinlan; Ulrich Schoettle; Saundra Stock; Kristin Kroeger Ptakowski; Jennifer Medicus Journal: J Am Acad Child Adolesc Psychiatry Date: 2007-11 Impact factor: 8.829
Authors: Chuan Mei Lee; Jessica Lutz; Allyson Khau; Brendon Lin; Nathan Phillip; Sara Ackerman; Petra Steinbuchel; Christina Mangurian Journal: Children (Basel) Date: 2022-08-03