Mental health care provision in community health centers and hospital emergency department utilization

Author:

Carey Kathleen1ORCID,Cole Megan B.1ORCID

Affiliation:

1. Department of Health Law, Policy and Management Boston University School of Public Health Boston Massachusetts USA

Abstract

AbstractObjectivesTo examine whether community health centers (CHCs) are effective in offsetting mental health emergency department (ED) visits.Data Sources and Study SettingThe HRSA Uniform Data System and the HCUP State ED Databases for Florida patients during 2012–2019.Study DesignWe identified CHC‐year‐specific service areas using patient origin zip codes. We then estimated panel data models for number of ED mental health visits per capita in a CHC's service area. Models measured CHC mental health utilization as number of visits, unique patients, and intensity (visits per patient).Principal FindingsCHC mental health utilization increased approximately 100% during 2012–2019. Increased CHC mental health provision was associated with small reductions in ED mental health utilization. An annual increase of 1000 CHC mental health care visits (5%) was associated with 0.44% fewer ED mental health care visits (p = 0.153), and an increase of 1000 CHC mental health care patients (15%) with 1.9% fewer ED mental health care visits (p = 0.123). An increase of 1 annual mental health visit per patient was associated with 16% fewer ED mental health care visits (p = 0.011).ConclusionsResults suggest that mental health provision in CHCs may reduce reliance on hospital EDs, albeit minimally. Policies that promote alignment of services between CHCs and local hospitals may accelerate this effect.

Funder

Agency for Healthcare Research and Quality

Publisher

Wiley

Subject

Health Policy

Reference23 articles.

1. National Institute of Mental Health. Mental Illness.https://www.nimh.nih.gov/health/statistics/mental-illness

2. Centers for Disease Control and Prevention. Improving Access to Children's Mental Health Care.https://www.cdc.gov/childrensmentalhealth/access.html

3. Acceptance of Insurance by Psychiatrists and the Implications for Access to Mental Health Care

4. National trends in mental health-related emergency department visits by children and adults, 2009–2015

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