TABLE 3—
Rates of Mental Disorder Assessment Discharged to the Community, Total and Stratified by Patient Characteristics: National Medicaid Analytic Extract Files (2006) and MarketScan Research Databases (2005–2007)
| Mental Disorder Assessment in Emergency Department |
|||||
| Characteristic | Privately Insured, % | Medicaid Insured, % | Privately Insured Patients, No. | Medicaid-Insured Patients, No. | AOR (95% CI) |
| Total | 57.3 | 47.8 | 1103 | 5155 | 1.58* (1.38, 1.81) |
| Age, y | |||||
| 21–34 | 57.9 | 47.0 | 480 | 2575 | 1.68* (1.37, 2.06) |
| 35–44 | 58.9 | 47.8 | 319 | 1525 | 1.70* (1.33, 2.18) |
| 45–64 | 54.6 | 49.9 | 304 | 1055 | 1.32* (1.01, 1.72) |
| Gender | |||||
| Men | 52.8 | 47.5 | 371 | 1636 | 1.36* (1.07, 1.72) |
| Women | 59.6 | 48.0 | 732 | 3519 | 1.69* (1.42, 2.01) |
| Recent mental health carea | |||||
| None | 56.0 | 43.0 | 686 | 2233 | 1.70* (1.43, 2.02) |
| Any | 59.5 | 51.5 | 417 | 2922 | 1.43* (1.16, 1.77) |
| Outpatient | 59.7 | 51.1 | 365 | 2572 | 1.47* (1.18, 1.84) |
| Inpatientd | 51.6 | 56.9 | 64 | 557 | 0.93* (0.54, 1.60) |
| Emergency | 62.5 | 55.4 | 120 | 1252 | 1.37* (0.92, 2.04) |
| Recent mental disorder diagnosisab | |||||
| Depression | 61.9 | 51.7 | 265 | 1620 | 1.62* (1.23, 2.12) |
| Bipolar | 54.5 | 51.9 | 77 | 880 | 1.16* (0.72, 1.89) |
| Anxiety | 59.6 | 51.6 | 156 | 1331 | 1.47* (1.04, 2.07) |
| Adjustment | 56.8 | 48.9 | 44 | 182 | 1.46* (0.71, 3.01) |
| Schizophrenia | 77.4 | 49.3 | 31 | 764 | 3.72* (1.63, 8.48) |
| Substance use | 63.6 | 54.5 | 107 | 1119 | 1.51* (0.99, 2.29) |
| Personality | 61.1 | 53.4 | 18 | 322 | 1.43* (0.45, 4.61) |
| Other | 57.1 | 52.5 | 56 | 672 | 1.24* (0.72, 2.15) |
| Recent self-harma | |||||
| Yes | 64.7 | 49.4 | 116 | 684 | 2.00* (1.29, 3.11) |
| No | 56.4 | 47.6 | 987 | 4471 | 1.54* (1.33, 1.77) |
| Current self-harm methodc | |||||
| Low lethality | 59.1 | 47.8 | 965 | 4644 | 1.67* (1.45, 1.93) |
| High lethalityd | 37.0 | 42.2 | 46 | 46 | 0.93* (0.42, 2.04) |
| Other or unknown | 48.9 | 50.3 | 92 | 376 | 1.38* (0.83, 2.30) |
| Current low-lethality self-harm method | |||||
| Cutting | 51.6 | 46.8 | 124 | 893 | 1.27* (0.87, 1.87) |
| Poisoning | 60.3 | 48.0 | 843 | 3767 | 1.74* (1.49, 2.03) |
Note. AOR = adjusted odds ratio; CI = confidence interval. Regressions control for patient age, patient gender, any outpatient mental health care in past 60 d, any inpatient mental health care in past 60 d, and any emergency department care in past 60 d. Separate models for each strata: insurance (Medicaid vs private) is the independent variable of interest, and Medicaid is the reference group.
On the basis of 60 d before emergency department visit.
For mental disorder variables, reference group is treatment episodes without the disorder.
High-lethality methods include firearm, drowning, suffocation, fall, fire, and motor vehicle; low lethality methods include cutting and poisoning; unknown includes unspecified or poorly specified.
Significant interaction (P < .05) with insurance status.
*P < .05.