title: Predictors of outpatient mental health clinic follow-up after hospitalization among Medicaid-enrolled young adults.
abstract: To assess demographic and clinical predictors of outpatient mental health clinic follow-up after inpatient psychiatric hospitalization among Medicaid-enrolled young adults.
  
  
  
  Using logistic regression and administrative claims data from the Maryland public mental health system and Maryland Medicaid for young adults ages 18-26 who were enrolled in Medicaid (N = 1127), the likelihood of outpatient mental health follow-up within 30 days after inpatient psychiatric hospitalization was estimated .
  
  
  
  Only 51% of the young adults had any outpatient mental health follow-up visits within 30 days of discharge. Being black and having a co-occurring substance use disorder diagnosis were associated with a lower probability of having a follow-up visit (OR = 0.60, P < 0.01 and OR = 0.36, P < 0.01, respectively). In addition, those who utilized any outpatient public mental health services during the 180 days prior to their index hospitalization (N = 625, 55.4%) were more likely to have a follow-up visit than those without prior outpatient use (OR = 2.45, P < 0.01). Prior Medicaid-reimbursed primary care visits were not significantly associated with follow-up.
  
  
  
  In this predominantly urban, low-income statewide sample of young adults hospitalized for serious psychiatric conditions, half did not connect with an outpatient mental healthcare provider following their discharge. Outpatient transition supports may be especially needed for young adults who were not receiving outpatient services prior to being admitted for psychiatric inpatient care, as well as for young adults with substance use disorders and African Americans.
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York, USA. marinol@nyspi.columbia.edu.
authors: Leslie
authors: L
authors: Marino
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Lawrence S
authors: LS
authors: Wissow
authors: Learning and Working During the Transition to Adulthood Rehabilitation Research and Training Center, Systems and Psychosocial Advances Research Center, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
authors: Maryann
authors: M
authors: Davis
authors: HillTop Institute, University of Maryland Baltimore County, Catonsville, Maryland, USA.
authors: Michael T
authors: MT
authors: Abrams
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York, USA.
authors: Lisa B
authors: LB
authors: Dixon
authors: Capitol Healthcare Network (VISN5) Mental Illness Research, Education and Clinical Center U.S. Department of Veterans Affairs, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors: Eric P
authors: EP
authors: Slade
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006760:Hospitalization; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D008297:Male; D008396:Maryland; D008484:Medicaid / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010045:Outpatients / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States; D055815:Young Adult
keywords: Medicaid; mental health service; young adult
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