Citation

Moore M, Jimenez N, Graves JM, Rue T, Fann JR, Rivara FP, Vavilala MS. J. Head Trauma Rehabil. 2018; 33(3): 177-184.

Affiliation

School of Social Work (Dr Moore), Harborview Injury Prevention and Research Center (Drs Moore, Jimenez, Rivara, and Vavilala), Institute of Translational Health Sciences (Dr Rue), and Departments of Anesthesiology and Pain Medicine (Drs Jimenez and Vavilala), Psychiatry and Behavioral Health (Dr Fann), and Pediatrics (Dr Rivara), University of Washington, Seattle; Seattle Children's Hospital, Seattle, Washington (Drs Jimenez and Rivara); and Washington State University College of Nursing, Spokane (Dr Graves).

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000348

PMID

29194176

Abstract

OBJECTIVE: To examine racial differences in mental health service utilization after hospitalization for traumatic brain injury (TBI) among children with Medicaid insurance. DESIGN AND MAIN MEASURES: Retrospective analysis of the MarketScan Multi-State Medicaid database from 2007 to 2012 was performed. Outpatient mental health service utilization (psychiatric and psychological individual and group services) was compared at TBI hospitalization, from discharge to 3 months and from 4 to 12 months after discharge, between children of non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, and "Other" racial groups. Multivariable mixed-effects Poisson regression models with robust standard errors were utilized.

RESULTS: A total of 5674 children (aged <21 years) were included in the study. There were no differences by race/ethnicity in mental health service utilization during hospitalization. At 3 months postdischarge, NHB children and children in the "Other" racial category were significantly less likely to receive outpatient mental health services than NHW children (NHB relative risk [RR] = 0.84; 95% confidence interval [CI], 0.72-0.98; Other RR = 0.72; 95% CI, 0.57-0.90). At 12 months, all racial minority children were significantly less likely to receive outpatient mental health services than NHW children (NHB RR = 0.84; 95% CI, 0.75-0.94; Hispanic RR = 0.72; 95% CI, 0.55-0.94; Other RR = 0.71; 95% CI, 0.60-0.84).

CONCLUSIONS: Racial disparities in utilization of outpatient mental health services exist for minority children hospitalized for TBI and insured by Medicaid. Future research should focus on improving transitions of care from inpatient to outpatient services for these children.

Language: en