Table 3.
Hazard ratios for the time to a behavioral health admission within 90 days postdischarge, by available followup services
| Model #1: OP, MAT (N=30,439) | Model #2: OP, MAT, IOP (N=6,787) | Model #3: OP, MAT, IOP, RES (N=3,339) | ||||
|---|---|---|---|---|---|---|
| Independent variables | Hazard ratio | 95% confidence interval | Hazard ratio | 95% confidence interval | Hazard ratio | 95% confidence interval |
| Follow-up servicesb | ||||||
| OP | 1.40** | 1.32–1.48 | 1.40** | 1.21–1.61 | 1.45* | 1.15–1.81 |
| MAT | .61** | .56–.67 | .60** | .48–.74 | .54** | .41–.73 |
| IOP | 1.06 | .84–1.35 | 1.45* | 1.03–2.04 | ||
| RES | .50** | .33–.76 | ||||
|
| ||||||
| State (reference: VT) | ||||||
| CT | .96 | .82–1.12 | 1.10 | .92–1.31 | 1.09 | .90–1.31 |
| IL | .75** | .65–.87 | -- | -- | -- | -- |
| IN | .41** | .34–.51 | .44** | .36–.56 | -- | -- |
| MN | .47** | .39–.58 | .53** | .42–.67 | .63** | .49–.80 |
| MO | .52** | .45–.61 | .55** | .46–.66 | -- | -- |
| NC | .39** | .33–.46 | -- | -- | -- | -- |
| NY | 1.00 | .87–1.15 | -- | -- | -- | -- |
| WI | .44** | .34–.55 | -- | -- | -- | -- |
| WV | .47** | .38–.58 | -- | -- | -- | -- |
|
| ||||||
| Basis of Medicaid eligibility is other than disabled (reference: disabled) | .99 | .94–1.04 | .86 | .74–1.00 | .86 | .72–1.01 |
|
| ||||||
| Female (reference: male) | .79** | .76–.83 | .76** | .68–.84 | .75** | .66–.86 |
|
| ||||||
| Age (reference: 40–59) | ||||||
| 18–39 | .98 | .93–1.03 | 1.11 | 1.00–1.25 | 1.07 | .92–1.24 |
| 60–64 | .68** | .60–.77 | .48** | .34–.68 | .47** | .31–.72 |
|
| ||||||
| Race/ethnicity (reference: white) | ||||||
| Black | 1.13** | 1.08–1.19 | .90 | .79–1.03 | .87 | .72–1.06 |
| Hispanic | 1.05 | .98–1.13 | .76* | .62–.95 | .82 | .66–1.02 |
| Other | .91 | .76–1.10 | .82 | .57–1.20 | .81 | .55–1.19 |
| Unknown | .95 | .83–1.09 | .88 | .59–1.33 | .92 | .53–1.57 |
|
| ||||||
| Comorbidities | ||||||
| Mental disorder | 1.29** | 1.23–1.35 | 1.04 | .93–1.16 | .75** | .64–.88 |
| Physical | .57** | .54–.59 | .51** | .46–.57 | .40** | .34–.46 |
|
| ||||||
| Index admission length of stay | .95** | .95–.96 | .95** | .93–.96 | .95** | .93–.97 |
|
| ||||||
| Substance use diagnosis at index | ||||||
| Alcohol only | 1.25** | 1.19–1.33 | 1.27** | 1.13–1.44 | 1.50** | 1.26–1.78 |
| Any opioid use disorder | 1.34** | 1.27–1.41 | 1.29** | 1.13–1.47 | 1.36** | 1.14–1.62 |
|
| ||||||
| Prior behavioral health services | ||||||
| Medication-assisted treatment | 1.11* | 1.01–1.22 | 1.08 | .90–1.29 | .99 | .81–1.21 |
| Inpatient | 2.81** | 2.68–2.95 | 2.49** | 2.20–1.82 | 2.10** | 1.74–2.55 |
| Outpatient | 1.20** | 1.14–1.26 | 1.29** | 1.15–1.44 | 1.33** | 1.16–1.54 |
Two dashes (--) indicate that the services was not included in the available data for that state.
a
Cox proportional hazards regression models
b
Followup service represents behavioral health treatments that occurred within 14 days of discharge from the index admission
*
p<.05,
**
p<.001
Source: 2008 Medicaid Analytic eXtract (MAX)