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Changes in Hospital Utilization Among Seriously Mentally Ill Patients Following Enrollment in an Integrated Primary and Behavioral Health Care Program

Changes in Hospital Utilization Among Seriously Mentally Ill Patients Following Enrollment in an Integrated Primary and Behavioral Health Care Program

Connecticut Medicine 81(5): 271-279

Integrated primary and behavioral health care models are emerging to improve access to care; however, the effect they have on utilization and expenditure has yet to be studied. A retrospective, longitudinal review of all patients (N = 343; 97% Medicaid) enrolled in our primary and behavioral health care program looked at hospital utilization up to a year before and after enrollment and estimated spending from Medicaid reimbursement data. There was a significant decrease in emergency department (ED) visits per person before enrollment vs after enrollment (2.39 vs 1.88, P = .009) with a decrease in those classified as high ED utilizers (four or more times in a year) from 22% to 16%, respectively (P = < .001). 'here was no change in inpatient admissions or length of stay. Medicaid saved $701.89 per client while costing the hospital $981.93 per client. Integrated health care may decrease ED utilization for clients with a serious mental ill- ness (SMI) while increasing savings for Medicaid and reducing hospital revenue.

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Accession: 053958226

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PMID: 29738128

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