Use of Mental Health and Primary Care Services Among Disadvantaged Young Adults

弱势年轻人对心理健康和初级保健服务的利用

基本信息

批准号：
7688078
负责人：
ERIC SLADE
金额：
$ 23.12万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-08-01 至 2011-07-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Not receiving needed mental health treatment is a major problem for vulnerable low-income young adults. This three-year study of approximately 11,000 young adults (ages 18 to 26 years old) who were enrolled in the Medicaid program from 2004 to 2005 and were authorized for extended use of mental health services will provide a comprehensive description of their utilization of inpatient and outpatient mental health services, use of psychotropic medications, and mental health treatment costs over a period of 18-months in length. The study will focus on understanding the particular roles of Medicaid insurance continuity (i.e., periods without lapses in coverage) and access to primary care services in enabling mental health treatment. A new framework that may clarify the complex relationships among insurance continuity, access to primary care services, and use of mental health services during the early years of adulthood will be examined in relation to two specific aims. First, we will examine how Medicaid/SCHIP coverage continuity and other indicators of access to primary care services during the past year are related to differences in these young adults' utilization of primary care services, utilization and costs of outpatient and inpatient mental health services, and utilization and costs of psychotropic medications over the subsequent 6-, 12-, and 18-months. Our second aim is to characterize how their utilization of primary care services and their utilization of outpatient and inpatient mental health services and psychotropic medications during a 6- month period of continuous Medicaid/SCHIP enrollment relate to their subsequent likelihood of disenrollment from Medicaid/SCHIP. Data needed to accomplish these aims will be assembled into a unique database that will contain information from a Medicaid/SCHIP information system and from a public MH system information system. These data will allow us to examine use of primary care and mental health services, as well treatment costs and Medicaid disenrollment over a 1 1/2 year period. By providing information about the impacts of Medicaid enrollment patterns on vulnerable young adults' access to mental health services during the period of transition into adult-oriented healthcare systems, and by providing information about the correlates of disenrollment from Medicaid, our research will inform policy reforms in the Medicaid program.

描述（由申请人提供）：未接受所需的心理健康治疗是脆弱的低收入年轻人的主要问题。这项为期三年的研究（18至26岁）从2004年到2005年就读了医疗补助计划，并获得了授权的医疗补助计划，并获得了扩展使用心理健康服务的全面描述，可以全面描述他们对住院和门诊精神健康服务的利用，精神健康治疗以及精神健康治疗的使用以及超过18米长期的精神卫生治疗成本。该研究将着重于了解医疗补助保险连续性的特定作用（即没有失误的期限），并在实现心理健康治疗方面获得了初级保健服务。一个新的框架，可以阐明在成年初期，将在成年初期进行保险连续性之间的复杂关系以及对精神卫生服务的使用。首先，我们将研究过去一年中的医疗补助/SCHIP覆盖范围连续性和其他获得初级保健服务的指标与这些年轻人对初级保健服务的利用，利用率和住院和住院精神卫生服务的利用和成本有关，以及随后6--12-，12-，12-，18个月的门诊和精神药物成本。我们的第二个目的是表征他们在6个月的连续医疗补助/SCHIP入学期间，他们对门诊和门诊精神健康服务以及精神药物的利用如何与他们随后的Medicaid/Schip剥夺了他们的可能性有关。实现这些目标所需的数据将集成到一个唯一的数据库中，该数据库将包含来自Medicaid/Schip信息系统和公共MH系统信息系统的信息。这些数据将使我们能够检查初级保健和精神卫生服务的使用，以及在1 1/2年期间的治疗费用和医疗补助撤销。通过提供有关医疗补助入学模式对弱势年轻人在过渡到成人医疗保健系统期间获得心理健康服务的影响的信息，并通过提供有关医疗补助的剥夺有关的信息的信息，我们的研究将为医疗补助计划中的政策改革提供依据。