Fewer than 15% of Washington state Medicaid beneficiaries received condition-concordant primary care follow-up within 30 days of emergency department visits for mental health conditions, substance use disorders or alcohol use disorder, according to a study published April 14 in JAMA Network Open.
Researchers from Seattle-based University of Washington analyzed 859,043 Medicaid ED visit claims from 367,245 Washington residents in 2022. The analysis included adults enrolled in Medicaid for at least 11 months who had at least one ED visit during the study period. Investigators used multivariable logistic regression models to identify characteristics associated with receiving condition-concordant primary care follow-up within 30 days.
Here are four things to know:
- Among mental health-related ED visits, 14.2% were followed by condition-concordant primary care within 30 days. Follow-up rates were 11.2% for substance use disorder-related visits and 11.1% for alcohol use disorder-related visits.
- Non-Hispanic Black beneficiaries had lower follow-up than all other racial groups studied. Non-Hispanic white individuals had a 4.47 percentage point higher probability of receiving follow-up after mental health-related ED visits and a 4.7 percentage point higher probability after substance use disorder-related visits.
- People experiencing homelessness were significantly less likely to receive follow-up care. Homelessness was associated with a 2.74 percentage point lower probability of follow-up after mental health-related ED visits.
- The findings point to ongoing barriers in care access and coordination after ED visits, particularly for behavioral health conditions, researchers said. The paper suggested targeted outreach, care navigation and stronger referral pathways could improve continuity of care.
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