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Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland.
Med Care. 2018 02; 56(2):153-161.MC

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.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Chen J
Department of Health Services Administration, School of Public Health, University of Maryland, College Park.
Novak P
Department of Health Services Administration, School of Public Health, University of Maryland, College Park.
Barath D
Department of Health Services Administration, School of Public Health, University of Maryland, College Park.
Goldman H
Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, MD.
Mortensen K
Department of Health Sector Management and Policy, School of Business Administration, University of Miami, Coral Gables, FL.

MeSH

AdolescentAdultAgedCommunity Mental Health CentersFemaleHealth PromotionHumansMarylandMedicaidMental HealthMiddle AgedPatient ReadmissionPreventive Health ServicesUnited StatesYoung Adult

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29271821

Citation

Chen, Jie, et al. "Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland." Medical Care, vol. 56, no. 2, 2018, pp. 153-161.
Chen J, Novak P, Barath D, et al. Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland. Med Care. 2018;56(2):153-161.
Chen, J., Novak, P., Barath, D., Goldman, H., & Mortensen, K. (2018). Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland. Medical Care, 56(2), 153-161. https://doi.org/10.1097/MLR.0000000000000850
Chen J, et al. Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland. Med Care. 2018;56(2):153-161. PubMed PMID: 29271821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Local Health Departments' Promotion of Mental Health Care and Reductions in 30-Day All-Cause Readmission Rates in Maryland. AU - Chen,Jie, AU - Novak,Priscilla, AU - Barath,Deanna, AU - Goldman,Howard, AU - Mortensen,Karoline, PY - 2017/12/23/pubmed PY - 2018/11/7/medline PY - 2017/12/23/entrez SP - 153 EP - 161 JF - Medical care JO - Med Care VL - 56 IS - 2 N2 - 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. SN - 1537-1948 UR - https://www.unboundmedicine.com/medline/citation/29271821/Local_Health_Departments'_Promotion_of_Mental_Health_Care_and_Reductions_in_30_Day_All_Cause_Readmission_Rates_in_Maryland_ DB - PRIME DP - Unbound Medicine ER -