Mental Health Parity and Addiction Equity Act and the Use of Outpatient Behavioral Health Services in the United States, 2005-2016
Mental Health Parity and Addiction Equity Act and the Use of Outpatient Behavioral Health Services in the United States, 2005-2016
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DOI：
10.2105/ajph.2019.305023
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发表时间：
2019-06-01
影响因子：
12.7
通讯作者：
Karakus, Mustafa
中科院分区：
文献类型：
--
作者：
Mulvaney-Day, Norah;Gibbons, Brent J.;Karakus, Mustafa
目标.为了评估我们的影响，2008年保罗Wellstone和皮特Domenici精神健康平价和成瘾公平法案（MHPAEA）的精神和物质使用障碍服务的私人，大集团雇主赞助的保险市场在美国。我们分析了IBM MarketScan商业数据库从2005年1月到2015年9月的数据，使用人口水平的中断时间序列回归来确定奇偶校验的实施是否与利用率和支出结果相关。MHPAEA与精神和物质使用障碍门诊服务的利用有显着的正相关。支出分解分析表明，利用率的增加是与MHPAEA相关的支出增加的主要驱动力。阿片类药物使用障碍和非阿片类药物使用障碍服务的分析发现，与利用和支出的关联不仅归因于阿片类药物使用障碍治疗的增加。MHPAEA与门诊精神和物质使用障碍服务的利用率呈正相关。这些趋势在MHPAEA后的5年期间继续存在，强调了这一政策变化与行为健康服务利用之间的长期关系。
Objectives. To assess We impact of the 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) on mental and substance use disorder services in the private, large group employer-sponsored insurance market in the United States.Methods. We analyzed data From the IBM MarketScan Commercial Database From January 2005 through September 2015 by using population-level interrupted time series regressions to determine whether parity implementation was associated with utilization and spending outcomes.Results. MHPAEA had significant positive associations with utilization of mental and substance use disorder outpatient services. A spending decomposition analysis indicated that increases in utilization were the primary drivers of increases in spending associated with MHPAEA. Analyses of opioid use disorder and nonopioid substance use disorder services found that associations with utilization and spending were not attributable only to increases in treatment of opioid use disorder.Conclusions. MHPAEA is positively associated with utilization of outpatient mental and substance use disorder services For Americans covered by large group employer sponsored insurance.Pubic Health Implications. These trends continued over the 5-year post-MHPAEA period, underscoring We long-term relationship between this policy change and utilization of behavioral health services.