Social networks and their relationship to mental health service use and expenditures among Medicaid beneficiaries.
OBJECTIVE
This study examined the relationship between social networks and mental health services utilization and expenditures.


METHODS
A sample of 522 Medicaid mental health consumers was randomly selected from the administrative records of Colorado's Department of Health Care Policy and Financing. The administrative records contain information on utilization of services and expenditures of Medicaid beneficiaries within Colorado's Mental Health Services. In addition to the administrative records, social network and psychosocial data were gathered through longitudinal survey interviews. The interviews were conducted at six-month intervals between 1994 and 1997. Measures used in the regression analysis included demographic characteristics, clinical diagnoses, the social network index, expenditures, and utilization variables.


RESULTS
The social network index was positively associated with utilization of and expenditures for inpatient services in local hospitals but negatively associated with expenditures for inpatient services in state hospitals or outpatient services. Relationships with family were negatively related to expenditures for outpatient services. Relationships with friends were positively associated with utilization of and expenditures for psychiatric inpatient services in local hospitals.


CONCLUSIONS
Consumers who had higher social network index scores utilized more inpatient psychiatric services in local hospitals and had higher expenditures than those who had lower scores. Consumers who had higher social network index scores also had lower expenditures for inpatient services in state hospitals and outpatient services than those who have lower scores. Findings suggest that social network is associated with mental health utilization and expenditures in various ways, associations that need to be researched further.
Kang
Soo Hyang
SH
Department of Health Policy and Management, School of Public Health, University of California, Berkeley, CA, USA. sookang@berkeley.edu
Wallace
Neal T
NT
Hyun
Jenny K
JK
Morris
Anne
A
Coffman
Janet
J
Bloom
Joan R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D003120:Colorado; D003625:Data Collection; D005260:Female; D005102:Health Expenditures; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D011446:Prospective Studies; D012944:Social Support; D014481:United States