75 percent of high hospital users in 13 poor NJ cities have behavioral health conditions

November 19, 2014

NEW BRUNSWICK, N.J. - More than a third of hospitalization costs in 13 low-income New Jersey communities are associated with behavioral health conditions, including mental health disorders and substance use, accounting for $880 million in annual inpatient costs, according to a new Rutgers study.

The report by the Rutgers Center for State Health Policy (CSHP) also found that 75 percent of patients who are classified as "high users" - those with at least four hospital stays between 2008-2011 - were diagnosed with one or more behavioral health conditions compared to 32 percent of less-frequent users.

In addition to hospitalizations of high users, the study also examined potentially preventable hospital admissions that could have been avoided with high-quality ambulatory care in the community, e.g., hospitalizations caused by uncontrolled diabetes. It found that 40 percent of preventable inpatient hospitalizations were associated with behavioral health conditions.

Sujoy Chakravarty, the report's lead author and assistant research professor at Rutgers CSHP, noted that the integration of physical and behavioral health services, particularly for the small number of patients who use a disproportionately high level of hospital services, would result in better care for these high-cost patients, decrease avoidable hospitalizations, and lead to substantial savings in costs.

"Coordination of behavioral and physical health care in the community setting may promote better health for complex patients, since unmanaged behavioral health problems often lead to poorly managed chronic medical conditions," said Chakravarty.

The report, funded by The Nicholson Foundation as part of its ongoing efforts to improve the quality and affordability of health care in New Jersey's underserved communities, sheds light on the importance of ensuring accessible behavioral health as part of population-based initiatives aimed at improving patient health and reducing avoidable hospitalizations and associated costs. The Foundation is supporting new evidence-based models of care that bring behavioral health expertise into community-based primary care settings.

Rachel Cahill, director of health care improvement and transformation at The Nicholson Foundation, said that New Jersey's vulnerable populations suffer from higher burdens of serious chronic illness and behavioral health disorders than others in our state and face significant, complex barriers to medical care.

"If we are committed to improving health outcomes for these vulnerable populations, we must increase availability of behavioral health services and the coordination of services by integrating physical and behavioral health care," Cahill said.

Although the study focused on hospital data in the 13 communities, the data and findings reflect populations throughout the state, including patients with Medicare, Medicaid, and commercial insurance, as well as the uninsured. Along with the Medicaid population, behavioral health issues were significantly present among patients with other sources of insurance. Therefore, the findings can guide the efforts of policymakers, insurers, and delivery systems in general, not just those specific to Medicaid, Cahill said.

The findings are based on analysis of New Jersey's uniform billing hospital discharge data from 2008-2011, available from the state Department of Health (DOH). Working with the DOH, researchers created a dataset that enabled them to follow patient utilization over time. The study population included hospitalizations of all adults (age 18 and over) living in one of 13 low- income communities in New Jersey: Asbury Park, Atlantic City, Camden, Elizabeth, Jersey City, New Brunswick, Newark, Paterson, Perth Amboy, Plainfield, Trenton, Union City, and Vineland. In some cases, neighboring towns also were included.
The study is part of a larger body of work from the Rutgers Center for State Health Policy funded by The Nicholson Foundation examining patterns of health care delivery and costs among low-income communities within New Jersey. To learn more about CSHP research, visit http://www.cshp.rutgers.edu/.

About Rutgers University: Established in 1766, Rutgers, The State University of New Jersey, is America's eighth oldest institution of higher learning and one of the nation's premier public research universities, educating more than 65,000 students and serving the people of New Jersey at campuses, divisions, research centers and clinical practices throughout the state. Rutgers' flagship, based in New Brunswick, is the only public institution in New Jersey represented in the prestigious Association of American Universities. Rutgers University is also a member of the Big Ten Conference and its academic counterpart, the Committee on Institutional Cooperation - a consortium of 15 world-class research universities.

About The Nicholson Foundation: The Nicholson Foundation works collaboratively to improve the quality and affordability of health care for vulnerable populations in New Jersey by transforming how it is paid for and delivered. The foundation's approach emphasizes partnerships and performance-based grant making; its goal is sustainable systems reform. For more information about the foundation, visit http://www.thenicholsonfoundation-newjersey.org.

Rutgers University

Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.