Characterizing behavioral health-related emergency department utilization among children with Medicaid: Comparing high and low frequency utilizers

Author/Creator ORCID

Date

2019-08-18

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Program

Citation of Original Publication

Lynch, Sean et al.; Characterizing behavioral health-related emergency department utilization among children with Medicaid: Comparing high and low frequency utilizers; Social Work in Health Care , Volume 58, Issue 8, 18 August, 2019; https://doi.org/10.1080/00981389.2019.1653418

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Public Domain Mark 1.0
This work was written as part of one of the author's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.

Subjects

Abstract

While the frequency of children’s behavioral health (BH)-related visits to the emergency department (ED) is rising nationwide, few studies have examined predictors of high rates of ED use. This study examines Florida Medicaid claims (2011–2012) for children age 0–18 who were seen in an emergency department (ED) for behavioral health (BH) conditions. A logistic regression model was used to explore factors associated with frequent ED use and patterns of psychotropic medication utilization. The majority (95%) of patients with at least one BH-related ED visit had three or fewer of these visits, but 5% had four or more. Seventy-four percent of ED visits were not associated with psychotropic medication, including over half (54%) of visits for attention deficit hyperactivity disorder (ADHD). Frequent ED use was higher among older children and those with substance use disorders. The implementation of interventions that reduce non-emergent ED visits through the provision of care coordination, social work services, and/or the use of community health workers as care navigators may address these findings.