Patterns in Medicaid Coverage and Service Utilization Among People with Serious Mental Illnesses.

Autor: Wilson AB; School of Social Work, University of North Carolina At Chapel Hill, 325 Pittsboro St., Campus Box 3550, Chapel Hill, NC, 27599-3550, USA. Amyblank@email.unc.edu., Phillips J; School of Social Work, University of North Carolina At Chapel Hill, 325 Pittsboro St., Campus Box 3550, Chapel Hill, NC, 27599-3550, USA., Parisi A; School of Social Work, University of North Carolina At Chapel Hill, 325 Pittsboro St., Campus Box 3550, Chapel Hill, NC, 27599-3550, USA., Ishler KJ; Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA., Villodas M; School of Social Work, University of North Carolina At Chapel Hill, 325 Pittsboro St., Campus Box 3550, Chapel Hill, NC, 27599-3550, USA., Francis A; School of Social Work, University of North Carolina At Chapel Hill, 325 Pittsboro St., Campus Box 3550, Chapel Hill, NC, 27599-3550, USA.
Jazyk: angličtina
Zdroj: Community mental health journal [Community Ment Health J] 2022 May; Vol. 58 (4), pp. 729-739. Date of Electronic Publication: 2021 Aug 27.
DOI: 10.1007/s10597-021-00878-7
Abstrakt: Disruptions in Medicaid adversely affect service use and outcomes among individuals with serious mental illnesses (SMI). A retrospective longitudinal study examined Medicaid coverage and service utilization patterns among individuals with SMI (N = 8358) from 2007 to 2010. Only 36% of participants were continuously enrolled in Medicaid and 20% experienced multiple enrollment disruptions. Mental health diagnosis did not predict continuous coverage; however, individuals with schizophrenia were 19% more likely to have multiple coverage disruptions than those with depression (b = - 0.21; p < 0.01). Single and multiple coverage disruptions were associated with decreased rates of outpatient service days utilized (IRR = 0.77 and 0.65, respectively, p < 0.001) and decreased odds of not using acute care services (OR  0.26 and 0.19, respectively, p < 0.001). Future research should explore mechanisms underlying Medicaid stability and develop interventions that facilitate insurance stability and service utilization.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: