Article Figures & Data
Figures
- Figure 1.
Criteria for inclusion in the sample and sequence of care use.
Tables
- Table 1.
Sample Characteristics of the Uninsured Adults with Mental Health Conditions Who Were Enrolled in the Low-Income Health Program in San Diego County from 2012 to 2013, Based on Enrollment and Claims Data
Characteristic Overall Had 15-Day Follow-Up Visit Did Not Have 15-Day Follow-Up Visit Had 30-Day Readmission Did Not Have 30-Day Readmission Sample size (n) 1,905 796 1,109 251 1,654 Had 15-day outpatient follow-up visit (%) 42 — 37 43 Had 30-day readmission (%) 13 12 14 — — Utilization within six months prior to index admission Average number of evaluation and management visits 0.66 0.79 0.56 0.70 0.65 Average number of emergency department visits 0.37 0.38 0.36 0.50 0.34 Index admission was medical (vs. surgical) (%) 67 67 66 69 66 Index admission was surgical (vs. medical) (%) 33 33 34 31 34 Average number of months enrolled prior to index admission 13.25 13.61 12.99 11.92 13.45 Severity indicators Length of stay of index admission in days 4.65 4.69 4.62 5.58 4.51 CDPS risk score 1.93 2.03 1.85 2.14 1.89 Substance abuse (%) 56 50 60 70 54 Depression (%) 55 56 54 57 54 Schizophrenia (%) 12 10 13 14 11 Bipolar Disorder (%) 44 46 42 48 43 Demographics (%) Female 49 53 47 42 51 Male 51 47 53 58 49 Age (%) 18 to 34 16 12 20 19 16 35 to 44 18 18 19 20 18 45 to 54 41 41 41 40 41 55 to 65 24 30 21 21 25 Race/Ethnicity (%) White 45 46 45 49 45 African American 9 7 11 7 10 Latino 17 19 16 16 17 Asian American/Pacific Islander 4 5 4 2 5 Other 1 1 1 2 0 Missing 24 23 24 25 24 CDPS (Chronic Illness and Disability Payment System) measures severity based on utilization of services with a combination of acute and chronic diagnoses.
- Table 2.
Marginal Effects from the Logistic Regression Models of Follow-Up Visits and Readmissions among the Uninsured Adults with Mental Health Conditions Who Were Enrolled in the Low-Income Health Program in San Diego County from 2012 to 2013, Based on Enrollment and Claims Data
15-Day Follow-Up Visit (N = 796) 30-Day Readmission (N = 251) Marginal Effect P value 95% CI Marginal Effect P value 95% CI Had 15-day outpatient follow-up visit — — — −2.5% .021 [−0.05, 0.00] (ref. group did not have 15-day follow-up visit) Use within 6 months prior to index admission Evaluation and management visits 5.8% .000 [0.04, 0.08] 0.9% .054 [0.00, 0.02] Emergency department visits 2.6% .194 [−0.01, 0.07] 3.2% .001 [0.01, 0.05] Index admission was surgical (ref. group medical) −5.5% .059 [−0.11, 0.00] −1.0% .696 [−0.06, 0.04] Average enrollment (in months) prior to index admission 0.3% .069 [0.00, 0.01] −0.4% .000 [−0.01, 0.00] Severity indicators Length of stay of index admission in days 1.2% .001 [0.00, 0.02] 0.5% .039 [0.00, 0.01] CDPS risk score 2.5% .004 [0.01, 0.04] 1.6% .000 [0.01, 0.02] Substance abuse −8.9% .000 [−0.12, −0.06] 4.9% .007 [0.01, 0.09] Depression −0.1% .606 [−0.05, 0.03] 1.1% .373 [−0.05, 0.00] Schizophrenia −4.8% .173 [−0.12, 0.02] 0.8% .719 [−0.04, 0.05] Bipolar disorder 4.8% .131 [−0.01, 0.11] 1.3% .525 [−0.03, 0.05] Demographics Female 2.3% .351 [−0.03, 0.07] −2.4% .103 [−0.05, 0.00] (ref. group male) Age (ref. group 18 to 34) 35 to 44 12.0% .000 [0.07, 0.17] −0.5% .789 [−0.04, 0.03] 45 to 54 10.1% .000 [0.07, 0.13] −1.4% .528 [−0.06, 0.03] 55 to 65 16.5% .000 [0.12, 0.21] −1.4% .550 [−0.06, 0.03] Race/ethnicity (ref. group white) African American −10.8% .007 [−0.19, −0.03] −3.0% .026 [−0.06, 0.00] Latino 1.7% .520 [−0.03, 0.07] −0.3% .857 [−0.03, 0.03] Asian American 0.9% .832 [−0.07, 0.09] −6.5% .015 [−0.12, −0.01] Other −5.4% .735 [−0.36, 0.26] 16.1% .224 [−0.10, 0.42] Missing −1.5% .652 [−0.08, 0.05] −0.2% .913 [−0.04, 0.04] CI, confidential interval. CDPS (Chronic Illness and Disability Payment System) measures severity based on utilization of services with a combination of acute and chronic diagnoses.
- Appendix A.
Multivariate Logistic Regression Results for Odds of an Outpatient Follow-Up Visits within 15 days of Discharge from the Index Hospitalization of the Uninsured Adults with Mental Health Conditions Who Were Enrolled in the Low-Income Health Program in San Diego County from 2012 to 2013, Based on Enrollment and Claims Data
Result Odds Ratio P value CI Length of stay of index admission 1.07 .002 [1.03, 1.12] Length of stay of index admission–quadratic term 1.00 .011 [1.00, 1.00] Chronic illness and disability payment system risk score 1.11 .005 [1.03, 1.20] Female (ref. group male) 1.11 .347 [0.90, 1.37] Age group (ref. group 18 to 34) 35 to 44 1.71 .000 [1.36, 2.15] 45 to 54 1.58 .000 [1.35, 1.85] 55 to 65 2.07 .000 [1.72, 2.50] Total duration of enrollment before index admission 1.01 .071 [1.00, 1.03] Index admission was surgical (ref. group medical) 0.79 .065 [0.61, 1.01] Number of evaluation and management visits 6 months prior to index admission 1.29 .000 [1.18, 1.40] Number of emergency department visits six months prior to index admission 1.12 .196 [0.94, 1.34] Substance abuse 0.68 .000 [0.60, 0.77] Depression 0.96 .606 [0.81, 1.13] Schizophrenia 0.81 .176 [0.59, 1.10] Bipolar disorder 1.23 .131 [0.94, 1.61] Race (ref. group white) African American 0.61 .007 [0.43, 0.87] Latino 1.07 .523 [0.86, 1.34] Asian American 1.04 .832 [0.73, 1.47] Other 0.79 .742 [0.19, 3.21] Missing 0.94 .652 [0.71, 1.23] Constant for outpatient visit model 0.25 0.000 [−1.90, −0.87] CI, confidential interval.
- Appendix B.
Multivariate Logistic Regression Results for Odds of All-Cause 30-Day Readmission, Regressed on Receipt of Timely Outpatient Follow-Up of the Uninsured Adults with Mental Health Conditions Who Were Enrolled in the Low-Income Health Program in San Diego County from 2012 to 2013, Based on Enrollment and Claims Data
Result Odds Ratio P value CI Timely outpatient follow-up after index admission 0.79 .022 [0.65, 0.97] Length of stay of index admission 1.06 .044 [1.00, 1.11] Length of stay of index admission–quadratic term 1.00 .054 [1.00, 1.00] Chronic illness and disability payment system risk score 1.16 .000 [1.08, 1.25] Female (ref. male) 0.80 .101 [0.62, 1.04] Age group (ref. 18 to 34) 35 to 44 0.95 .788 [0.68, 1.34] 45 to 54 0.89 .530 [0.60, 1.30] 55 to 65 0.88 .533 [0.58, 1.33] Total duration of enrollment before index admission 0.97 .000 [0.95, 0.98] Index admission was surgical (ref. medical) 0.89 .604 [0.56, 1.40] Number of evaluation and management visits 6 months prior to index admission 1.09 .053 [1.00, 1.18] Number of emergency department visits six months prior to index admission 1.34 .001 [1.13, 1.58] Substance abuse 1.59 .009 [1.12, 1.27] Depression 1.10 .370 [0.89, 1.37] Schizophrenia 1.08 .714 [0.72, 1.60] Bipolar disorder 1.12 .523 [0.79, 1.60] Race (ref. white) African American 0.75 .031 [0.57, 0.97] Latino 0.98 .858 [0.76, 1.26] Asian American 0.47 .059 [0.22, 1.03] Other 2.83 .118 [0.77, 10.44] Missing 1.02 .913 [0.73, 1.41] Constant for outpatient visit model 0.11 0.000 [−2.97, −1.43] CI, confidential interval.
