TY  - JOUR
PY  - 2012//
TI  - Payment Source and Emergency Management of Deliberate Self-Harm
JO  - American journal of public health
A1  - Marcus, Steven C.
A1  - Bridge, Jeffrey A.
A1  - Olfson, Mark
SP  - 1145
EP  - 1153
VL  - 102
IS  - 6
N2  - Objectives. We investigated whether health insurance type (private vs Medicaid) influences the delivery of acute mental health care to patients with deliberate self-harm. Methods. Using National Medicaid Analytic Extract Files (2006) and MarketScan Research Databases (2005-2007), we analyzed claims focusing on emergency episodes of deliberate self-harm of Medicaid- (n = 8228) and privately (n = 2352) insured adults. We analyzed emergency department mental health assessments and outpatient mental health visits in the 30 days following the emergency visit for discharged patients. Results. Medicaid-insured patients were more likely to be discharged (62.7%), and among discharged patients they were less likely to receive a mental health assessment in the emergency department (47.8%) and more likely to receive follow-up outpatient mental health care (52.9%) than were privately insured patients (46.9%, 57.3%, and 41.2%, respectively). Conclusions. Acute emergency management of deliberate self-harm is less intensive for Medicaid- than for privately insured patients, although discharged Medicaid-insured patients are more likely to receive follow-up care. Programmatic reforms are needed to improve access to emergency mental health services, especially in hospitals that serve substantial numbers of Medicaid-insured patients. (Am J Public Health. Published online ahead of print April 19, 2012: e1-e9. doi:10.2105/AJPH.2011.300598).<p />  <p>Language: en</p>
LA  - en
SN  - 0090-0036
UR  - http://dx.doi.org/10.2105/AJPH.2011.300598
ID  - ref1
ER  -