Mental health resource utilization and health care costs associated with race and comorbid anxiety among medicaid enrollees with major depressive disorder

Chung Hsuen Wu, Steven R. Erickson, John D. Piette, Rajesh Balkrishnan

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Disclosure: This study was a part of Dr Wu's original doctoral dissertation, "Interactive Associations of Race and Comorbidity in Medication Treatment and Outcomes of Medicaid Enrolled Patients with Major Depressive Disorder." The study was not funded by any resource. Objective: The objective of this study was to assess the association among race, comorbid anxiety, and mental health resource utilization among Medicaid enrollees with major depressive disorder (MDD). Methods: A retrospective cross-sectional study design was used to identify adult patients with MDD newly initiating an antidepressant between January 1, 2004, and December 31, 2006, from the MarketScan Multi-State Medicaid Database. Measures of mental health resource utilization included mental health-related office visits, hospitalizations, emergency department visits, and health care costs. The associations of mental health resource utilization with race and comorbid anxiety were examined respectively using multivariable logistic regression, negative binominal regression, and log-transformed linear regression models. Results: A total of 3083 Medicaid enrollees with MDD were included. Approximately 25% of patients had comorbid anxiety. Caucasians were more likely to have comorbid anxiety than African Americans (30.2% vs 16.4%, p <.01). After controlling for covariates, comorbid anxiety was significantly associated with more frequent mental health resource utilization. African Americans were significantly less likely than Caucasians to have mental health-related office visits (OR, 0.54; 95% CI, 0.45-0.66) but more likely to be hospitalized (OR, 2.57; 95% CI, 1.84-3.60) and to have emergency department visits (OR, 1.52; 95% CI, 1.05-2.19). Conclusions: Comorbid anxiety was positively associated with mental health resource utilization among Medicaid enrollees with MDD. Health disparities in health care utilization between African Americans and Caucasians still exist.

Original languageEnglish
Pages (from-to)78-88
Number of pages11
JournalJournal of the National Medical Association
Volume104
Issue number1-2
Publication statusPublished - Jan 2012
Externally publishedYes

Fingerprint

Health Resources
Medicaid
Major Depressive Disorder
Health Care Costs
Mental Health
Anxiety
African Americans
Office Visits
Hospital Emergency Service
Linear Models
Patient Acceptance of Health Care
Disclosure
Antidepressive Agents
Comorbidity
Hospitalization
Cross-Sectional Studies
Logistic Models
Databases
Health

Keywords

  • Anxiety
  • Depression
  • Health resource utilization
  • Medicaid
  • Race/ethnicity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mental health resource utilization and health care costs associated with race and comorbid anxiety among medicaid enrollees with major depressive disorder. / Wu, Chung Hsuen; Erickson, Steven R.; Piette, John D.; Balkrishnan, Rajesh.

In: Journal of the National Medical Association, Vol. 104, No. 1-2, 01.2012, p. 78-88.

Research output: Contribution to journalArticle

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abstract = "Disclosure: This study was a part of Dr Wu's original doctoral dissertation, {"}Interactive Associations of Race and Comorbidity in Medication Treatment and Outcomes of Medicaid Enrolled Patients with Major Depressive Disorder.{"} The study was not funded by any resource. Objective: The objective of this study was to assess the association among race, comorbid anxiety, and mental health resource utilization among Medicaid enrollees with major depressive disorder (MDD). Methods: A retrospective cross-sectional study design was used to identify adult patients with MDD newly initiating an antidepressant between January 1, 2004, and December 31, 2006, from the MarketScan Multi-State Medicaid Database. Measures of mental health resource utilization included mental health-related office visits, hospitalizations, emergency department visits, and health care costs. The associations of mental health resource utilization with race and comorbid anxiety were examined respectively using multivariable logistic regression, negative binominal regression, and log-transformed linear regression models. Results: A total of 3083 Medicaid enrollees with MDD were included. Approximately 25{\%} of patients had comorbid anxiety. Caucasians were more likely to have comorbid anxiety than African Americans (30.2{\%} vs 16.4{\%}, p <.01). After controlling for covariates, comorbid anxiety was significantly associated with more frequent mental health resource utilization. African Americans were significantly less likely than Caucasians to have mental health-related office visits (OR, 0.54; 95{\%} CI, 0.45-0.66) but more likely to be hospitalized (OR, 2.57; 95{\%} CI, 1.84-3.60) and to have emergency department visits (OR, 1.52; 95{\%} CI, 1.05-2.19). Conclusions: Comorbid anxiety was positively associated with mental health resource utilization among Medicaid enrollees with MDD. Health disparities in health care utilization between African Americans and Caucasians still exist.",
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AB - Disclosure: This study was a part of Dr Wu's original doctoral dissertation, "Interactive Associations of Race and Comorbidity in Medication Treatment and Outcomes of Medicaid Enrolled Patients with Major Depressive Disorder." The study was not funded by any resource. Objective: The objective of this study was to assess the association among race, comorbid anxiety, and mental health resource utilization among Medicaid enrollees with major depressive disorder (MDD). Methods: A retrospective cross-sectional study design was used to identify adult patients with MDD newly initiating an antidepressant between January 1, 2004, and December 31, 2006, from the MarketScan Multi-State Medicaid Database. Measures of mental health resource utilization included mental health-related office visits, hospitalizations, emergency department visits, and health care costs. The associations of mental health resource utilization with race and comorbid anxiety were examined respectively using multivariable logistic regression, negative binominal regression, and log-transformed linear regression models. Results: A total of 3083 Medicaid enrollees with MDD were included. Approximately 25% of patients had comorbid anxiety. Caucasians were more likely to have comorbid anxiety than African Americans (30.2% vs 16.4%, p <.01). After controlling for covariates, comorbid anxiety was significantly associated with more frequent mental health resource utilization. African Americans were significantly less likely than Caucasians to have mental health-related office visits (OR, 0.54; 95% CI, 0.45-0.66) but more likely to be hospitalized (OR, 2.57; 95% CI, 1.84-3.60) and to have emergency department visits (OR, 1.52; 95% CI, 1.05-2.19). Conclusions: Comorbid anxiety was positively associated with mental health resource utilization among Medicaid enrollees with MDD. Health disparities in health care utilization between African Americans and Caucasians still exist.

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