Assessing the quality measure for follow-up care after children’s psychiatric hospitalizations

Academic Article


  • OBJECTIVES: Medicaid and Children’s Health Insurance Program plans publicly report quality measures, including follow-up care after psychiatric hospitalization. We aimed to understand failure to meet this measure, including measurement definitions and enrollee characteristics, while investigating how follow-up affects subsequent psychiatric hospitalizations and emergency department (ED) visits. METHODS: Administrative data representing Alabama’s Children’s Health Insurance Program from 2013 to 2016 were used to identify qualifying psychiatric hospitalizations and follow-up care with a mental health provider within 7 to 30 days of discharge. Using relaxed measure definitions, follow-up care was extended to include visits at 45 to 60 days and visits to a primary care provider. Logit regressions estimated enrollee characteristics associated with follow-up care and, separately, the likelihood of subsequent psychiatric hospitalizations and/or ED visits within 30, 60, and 120 days. RESULTS: We observed 1072 psychiatric hospitalizations during the study period. Of these, 356 (33.2%) received follow-up within 7 days and 566 (52.8%) received it within 30 days. Relaxed measure definitions captured minimal additional follow-up visits. The likelihood of follow-up was lower for both 7 days (218 percentage points; 95% confidence interval [CI] 226 to 210 percentage points) and 30 days (226 percentage points; 95% CI 235 to 217 percentage points) regarding hospitalization stays of $8 days. Meeting the measure reduced the likelihood of subsequent psychiatric hospitalizations within 60 days by 3 percentage points (95% CI 26 to 21 percentage point). CONCLUSIONS: Among children, receipt of timely follow-up care after a psychiatric hospitalization is low and not sensitive to measurement definitions. Follow-up care may reduce the need for future psychiatric hospitalizations and/or ED visits.
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    Digital Object Identifier (doi)

    Author List

  • Blackburn J; Sharma P; Corvey K; Morrisey MA; Menachemi N; Sen B; Caldwell C; Becker D
  • Start Page

  • 834
  • End Page

  • 843
  • Volume

  • 9
  • Issue

  • 11