title: Quality of Diabetes Care Among Adult Medicaid Enrollees With Mental Disorders.
abstract: In light of the national trend toward integrating mental and general medical care, this study examined disparities in diabetes treatment among Medicaid recipients in a nonintegrated, managed care behavioral health carve-out system.
  
  
  
  A retrospective study of Medicaid claims (July 2009-June 2010) compared quality of diabetes treatment among 21,015 patients with and without mental disorders.
  
  
  
  Presence of a mental disorder was associated with higher use of outpatient and primary care services for diabetes, lower rates of hospitalizations for diabetes, and higher odds of receiving three or more quality measures for diabetes care. Patients with serious mental illness had better diabetes care compared with patients with other mental disorders and patients with no mental disorders.
  
  
  
  Findings suggest that managed care behavioral health carve-out systems should be considered among the range of approaches for improving treatment for diabetes among persons with comorbid mental disorders, particularly serious mental disorders.
authors.affiliation: The authors are with the Center for Mental Health Policy and Services Research, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (e-mail: lizn@upenn.edu ). Dr. Rothbard is also with the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia. Dr. Hurford is also with Community Care Behavioral Health Organization, Pittsburgh, Pennsylvania.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Noll
authors.affiliation: The authors are with the Center for Mental Health Policy and Services Research, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (e-mail: lizn@upenn.edu ). Dr. Rothbard is also with the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia. Dr. Hurford is also with Community Care Behavioral Health Organization, Pittsburgh, Pennsylvania.
authors.forename: Aileen B
authors.initials: AB
authors.lastname: Rothbard
authors.affiliation: The authors are with the Center for Mental Health Policy and Services Research, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (e-mail: lizn@upenn.edu ). Dr. Rothbard is also with the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia. Dr. Hurford is also with Community Care Behavioral Health Organization, Pittsburgh, Pennsylvania.
authors.forename: Trevor R
authors.initials: TR
authors.lastname: Hadley
authors.affiliation: The authors are with the Center for Mental Health Policy and Services Research, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (e-mail: lizn@upenn.edu ). Dr. Rothbard is also with the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia. Dr. Hurford is also with Community Care Behavioral Health Organization, Pittsburgh, Pennsylvania.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Hurford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult