Behavioral Health's Integration Within a Care Network and Health Care Utilization
Collections
Author/Creator ORCID
Date
Type of Work
Department
Program
Citation of Original Publication
McClellan, Chandler et al.; Behavioral Health's Integration Within a Care Network and Health Care Utilization; Health Services Research, 53, 6, p 4543-4564, 30 May, 2018; https://doi.org/10.1111/1475-6773.12983
Rights
This item is likely protected under Title 17 of the U.S. Copyright Law. Unless on a Creative Commons license, for uses protected by Copyright Law, contact the copyright holder or the author.
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.
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
Objective
Examine how behavioral health (BH) integration affects health care costs, emergency department (ED) visits, and inpatient admissions.
Data Sources/Study Setting
Truven Health MarketScan Research Databases.
Study Design
Social network analysis identified “care communities” (providers sharing a high number of patients) and measured BH integration in terms of how connected, or central, BH providers were to other providers in their community. Multivariable generalized linear models adjusting for age, sex, number of prescriptions, and Charlson comorbidity score were used to estimate the relationship between the centrality of BH providers and health care utilization of BH patients.
Data Collection/Extraction Methods
Used outpatient, inpatient, and pharmacy claims data from six Medicaid plans from 2011 to 2013 to identify study outcomes, comorbidities, providers, and health care encounters.
Principal Findings
Behavioral health centrality ranged from 0 (no BH providers) to 0.49. Relative to communities at the median BH centrality (0.06), in 2012, BH patients in communities at the 75th percentile of BH centrality (0.31) had 0.2 fewer admissions, 2.1 fewer all-cause ED visits, and accrued $1,947 fewer costs, on average.
Conclusions
Increased behavioral centrality was significantly associated with a reduced number of ED visits, less frequent inpatient admissions, and lower overall health care costs.