Hospital Readmission Among Medicaid Patients with an Index Hospitalization for Mental and/or Substance Use Disorder

• Published in: The journal of behavioral health services & research Vol. 40; no. 2; pp. 207 - 221
• Main Authors: Mark, Tami, Tomic, Karen Smoyer, Kowlessar, Niranjana, Chu, Bong Chul, Vandivort-Warren, Rita, Smith, Shelagh
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.04.2013
• Subjects: Adolescent; Adult; Aged; Community and Environmental Psychology; Databases, Factual; Female; Health; Health Informatics; Health Promotion and Disease Prevention; Health Psychology; Hospitalization; Hospitals; Humans; Male; Medicaid; Medicine; Medicine & Public Health; Mental Disorders - epidemiology; Middle Aged; Models, Statistical; Patient Readmission - statistics & numerical data; Psychiatry; Public Health; Quality Indicators, Health Care; Readmission; Substance abuse disorders; Substance-Related Disorders - epidemiology; United States; Young Adult; United States; Hospital Readmission; Community Mental Health Center; Index Admission; Behavioral Health; Readmission Rate
• ISSN: 1094-3412; 1556-3308
• DOI: 10.1007/s11414-013-9323-5

Hospital readmission rates are increasingly used as a performance indicator. Whether they are a valid, reliable, and actionable measure for behavioral health is unknown. Using the MarketScan Multistate Medicaid Claims Database, this study examined hospital- and patient-level predictors of behavioral health readmission rates. Among hospitals with at least 25 annual admissions, the median behavioral health readmission rate was 11% (10th percentile, 3%; 90th percentile, 18%). Increased follow-up at community mental health centers was associated with lower probabilities of readmission, although follow-up with other types of providers was not significantly associated with hospital readmissions. Hospital average length of stay was positively associated with lower readmission rates; however, the effect size was small. Patients with a prior inpatient stay, a substance use disorder, psychotic illness, and medical comorbidities were more likely to be readmitted. Additional research is needed to further understand how the provision of inpatient services and post-discharge follow-up influence readmissions.