Predictors of admission to acute inpatient psychiatric care among children enrolled in Medicaid.
This study examined acute inpatient psychiatric admissions among child Medicaid recipients with a mental health diagnosis in one Midwestern state. The authors used multivariable logistic regression to determine the demographic, clinical, and service factors associated with admissions among 51,233 Medicaid enrolled children 3-17 years old who were identified as having a mental health diagnosis. Compared to available data from other states, the overall acute admission rate was low (2.5 %). Clinical factors were the strongest predictors of hospitalization. Youths with mood, disruptive and psychotic disorder diagnoses were 14.1, 6.2, and 5.8 times more likely than other mental health beneficiaries to experience one or more acute inpatient psychiatric admissions. Other predictors of acute admission included prior hospitalization, receipt of two or more concurrent psychotropic medications, older age, and urban residence. A low rate of acute inpatient admissions may indicate successful delivery of community-based mental health services; conversely, it may suggest underservice to youths with mental health need, particularly those in rural areas. Implications for publicly funded children's mental health care are discussed.
School of Social Work, University of British Columbia, 2080 West Mall, Room 239, Vancouver, BC, V6T 1Z2, Canada, stephanie.bryson@ubc.ca.
Stephanie A
SA
Bryson
Becci A
BA
Akin
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008484:Medicaid; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data; D019964:Mood Disorders / Q000188:drug therapy / Q000453:epidemiology; D015999:Multivariate Analysis; D011567:Psychiatric Department, Hospital; D011618:Psychotic Disorders / Q000188:drug therapy / Q000453:epidemiology; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012307:Risk Factors; D014481:United States; D014505:Urban Population
D011619:Psychotropic Drugs