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Association of mental health disorders and Medicaid with ED admissions for ambulatory care-sensitive condition conditions.
- Source :
-
The American journal of emergency medicine [Am J Emerg Med] 2016 May; Vol. 34 (5), pp. 820-4. Date of Electronic Publication: 2016 Jan 21. - Publication Year :
- 2016
-
Abstract
- Introduction: Adult Medicaid enrollees are more likely to have mental health disorders (MHDs) than privately insured patients and also have high rates of emergency department (ED) visits for ambulatory care-sensitive conditions (ACSCs). We aimed to evaluate the association of MHD and insurance type with ED admissions for ACSC in the United States.<br />Methods: We conducted a cross-sectional study of ED visits made by adults aged 18 to 64 years using the corrected 2011 National Emergency Department Survey. Using multivariable logistic regression analysis, we controlled for sociodemographics and clinical variables to determine the association between insurance type, MHD, Medicaid, and MHD (as an interaction variable) and ED admissions for ACSC.<br />Results: There were 131 million ED visits in 2011; after exclusions, 1.4 million admissions were included in our study. Of all ED visits, 44.7% had an MHD, of which 49.9% were covered by Medicaid and 38.1% were covered by private insurance. A total of 32.6% (95% confidence interval, 32.5%-32.7%) of ED admissions were for an ACSC. Medicaid-covered ED visits were more likely to result in ACSC hospital admission (odds ratio, 1.32; 95% confidence interval, 1.30-1.35) compared with visits covered by private insurance. Among patients with MHD, those with Medicaid insurance had 1.6 times the odds of ACSC admission compared with those privately insured.<br />Conclusion: Among all ED admissions, patients covered by Medicaid are more likely to be admitted for an ACSC when compared with those covered by private insurance, with a larger association being present among patients with MHD comorbidities.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Cross-Sectional Studies
Female
Humans
Logistic Models
Male
Mental Disorders economics
Middle Aged
Retrospective Studies
United States
Ambulatory Care
Emergency Service, Hospital statistics & numerical data
Insurance, Health statistics & numerical data
Medicaid statistics & numerical data
Mental Disorders therapy
Patient Admission statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8171
- Volume :
- 34
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of emergency medicine
- Publication Type :
- Academic Journal
- Accession number :
- 26887865
- Full Text :
- https://doi.org/10.1016/j.ajem.2016.01.023