Table 3. Health, SDOH, and Quality Outcomes From Difference-in-Differences Analyses.
| Characteristica | SMI | Mild and moderate mental illness | ||
|---|---|---|---|---|
| Baseline | Estimate (95% CI) | Baseline | Estimate (95% CI) | |
| Health outcomes | ||||
| Readmission after mental health hospitalization | 23.8 | −3.1 (−10.3 to 4.0) | 9.3 | 3.9 (−1.2 to 9.1) |
| Self-harm incidents | 4.3 | 0.1 (−0.6 to 0.8) | 1.0 | −0.1 (−0.3 to 0.1) |
| Cardiac events (IP or ED) | 9.1 | 0.2 (−1.6 to 2.0) | 5.1 | −0.9 (−1.5 to −0.3)a |
| Hospitalizations for diabetes | 63.7 | 13.6 (−16.3 to 43.5) | 38.1 | −18.0 (−37.8 to 1.8) |
| SDOH related | ||||
| Employed | 30.9 | −0.9 (−1.5 to −0.2)a | 42.1 | −0.6 (−1.3 to 0.1) |
| Arrested | 4.3 | 0.5 (0.01 to 1.0)a | 3.1 | 0.2 (−0.1 to 0.5) |
| Homeless | 15.2 | 0.2 (−0.3 to 0.7) | 9.1 | −0.1 (−0.4 to 0.3) |
| Quality measures | ||||
| Comprehensive diabetes care: HbA1c | 83.2 | −0.1 (−3.0 to 2.9) | NA | NA |
| Monitoring of persistent medications | 86.9 | −0.9 (−4.4 to 2.7) | NA | NA |
| Diabetes screening for people using antipsychotics | 78.0 | 1.2 (−1.4 to 3.8) | NA | NA |
| Antidepressant medication management: acute | 47.3 | 2.6 (−3.2 to 8.4) | NA | NA |
| Antidepressant medication management: continuation | 31.5 | 2.0 (−2.4 to 6.5) | NA | NA |
Abbreviations: ED, emergency department; HbA1c, hemoglobin A1c; IP, inpatient; NA, not applicable; SDOH, social determinants of health; SMI, severe mental illness.
a
Unit of observation for health outcomes and SDOH measures is the person quarter. Measures are presented as rates per 1000 member months, with 1 exception: hospitalizations for diabetes are shown as rates per 100 000 member months. The unit of observation for quality measures is the person year.