Hospital readmission among medicaid patients with an index hospitalization for mental and/or substance use disorder

J Behav Health Serv Res. 2013 Apr;40(2):207-21. doi: 10.1007/s11414-013-9323-5.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Medicaid*
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Models, Statistical
  • Patient Readmission / statistics & numerical data*
  • Quality Indicators, Health Care
  • Substance-Related Disorders / epidemiology*
  • United States
  • Young Adult