142nd APHA Annual Meeting and Exposition

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304933
Trends in Medical Care Utilization and Barriers to Care among Adults with Serious Mental Illness: 1997-2012

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 2:30 PM - 2:50 PM

Xiaoling Xiang, M.Phil , School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
Christopher R. Larrison, PhD , School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
John Brekke, PhD , School of Social Work, University of Southern California, Los Angeles, CA
Karen Tabb, PhD, MSW , School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
Audio (mp3) recording Recorded Presentation (mp4)
Objectives: People with serious mental illness have increased risk for physical illness, suffer worse health outcomes and higher mortality rate. We assessed the national trends in healthcare utilization and barriers to medical care among adults with serious mental illness over the past 16 years.

Methods: Using data from the National Health Interview Survey of 1997-2012, we selected samples of adults (n=16513) with serious mental illness (operationalized as K6 score ≥13). Chi-square test and logistic regression were used to examine the association of survey year with selected measures of medical care utilization (contact with a general doctor, hospitalization, emergency room visits) and barriers to care in the past 12 months.

Results: There were no significant linear trends on the prevalence of contact with a general doctor or hospitalization in the past 12 months. However, the prevalence of having 2 or more visits to the emergency department increased from 24.2% in 1997 to 29.2% in 2012 (OR=1.02, p<.001). The prevalence of reported barriers to care also increased, including difficulty in getting an appointment (10.4%-18.4%, OR=1.03, p<.001), having forgone medical care (22.9%-36.7%, AOR=1.03, p<.001) or prescription medicines (26.4%-39.6%, AOR=1.04, p<.001) owing to cost. There were significant disparities in receiving care and reported barriers to care by socio-demographic characteristics, insurance coverage and count of medical conditions.                   

Conclusions: Utilization of ambulatory and inpatient care among adults with serious mental illness remained largely unchanged in recent years, whereas emergency care use has been increased, along with barriers to care.

Learning Areas:

Public health or related public policy
Public health or related research

Learning Objectives:
Analyze the trends in healthcare utilization including ambulatory care, hospitalization and visits to the Emergency Department (ED) by adults with SMI from 1997 to 2012. Identify barriers to healthcare access and utilization by adults with SMI from 1997 to 2012. Discuss the possible influences on the trends in healthcare utilization and barriers to care in the past 16 years, and explore ways to improve access to primary care and reduce overutilization of ED.

Keyword(s): Health Care Access, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I'm a doc student. I have strong analytical skills and have published papers. I have worked closely with profs who are experts in the subject area. I wrote a paper on the subject matter and recently passed this paper as my qualifying paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4349.0: Emergency Departments and Mental Health: Utilization, Outcomes and Service Design