Low Follow-Up After Behavioral ED Care

Overview

A study found that fewer than 15% of Medicaid ED visits for mental health conditions and about 11% for substance use disorders were followed by condition-concordant primary care within 30 days. Disparities in follow-up rates were noted among racial groups and individuals experiencing homelessness.

Background

The low rates of follow-up care after emergency department (ED) visits for mental health and substance use disorders raise concerns about continuity of care for vulnerable populations. This issue is particularly significant in light of recent policy changes that may affect access to primary care services. Understanding these follow-up patterns is crucial for improving care coordination and health outcomes.

Data Highlights

Key Findings

• Less than 15% of ED visits for mental health conditions resulted in follow-up care.
• Approximately 11% of ED visits for substance use disorders were followed by condition-concordant primary care.
• Non-Hispanic Black beneficiaries had the lowest predicted probability of follow-up compared to other racial groups.
• Beneficiaries experiencing homelessness had lower follow-up rates, particularly after mental health-related visits.
• Higher comorbidity burden was associated with greater probability of follow-up across all conditions.
• Rural residence showed varying effects on follow-up rates depending on the condition.

Clinical Implications

The findings highlight the need for improved care coordination and outreach strategies to enhance follow-up rates for patients with mental health and substance use disorders. Addressing disparities in follow-up care is essential for ensuring equitable access to primary care services.

Conclusion

The study underscores persistent challenges in achieving continuity of care for patients with behavioral health needs, even within integrated care models. Further efforts are necessary to improve follow-up rates and access to care.

Related Resources & Content

1. Staloff JA, et al., JAMA Network Open, 2023 -- Primary Care Follow-Up After Mental Health or Substance Use ED Visit in Medicaid
2. Journal of Medical Internet Research (JMIR) — Rethinking Postdischarge Intervention Evaluation
3. Critical Care (Springer) — Beyond attendance: reconsidering evidence and context in post-intensive care unit follow-up clinic models
4. JAMA Pediatrics — Coding Error in Study of Behavior Problems in Low-Income Children
5. conexiant — Behavior Guidance Often Poorly Cited
6. Recommended Standard Care for People with Suicide Risk | SAMHSA
7. Primary Care Follow-Up After Mental Health or Substance Use ED Visit in Medicaid
8. Opioids | ACEP