Skip to Main Content
 

Global Search Box

 
 
 
 

Files

File List


osu1054149270.pdf (897.19 KB)

ETD Abstract Container

Abstract Header

Inlfuence of diagnoses, race, medicaid enrollment status on health service utilization among the seriously mentally disabled population

Chipps, Esther M
http://rave.ohiolink.edu/etdc/view?acc_num=osu1054149270

Abstract Details

2003, Doctor of Philosophy, Ohio State University, Nursing.
Equitable access to physical health services and mental health services among the severely mentally disabled (SMD) population is a significant public health concern. This research has four aims: 1. To describe the seriously mentally disabled population of Franklin County, Ohio, receiving services from the public mental health system. 2. To describe and to compare the Medicaid enrolled seriously mentally disabled population with the non-Medicaid enrolled serious mentally disabled population with respect to race, age, sex, and psychiatric diagnoses. 3. To examine the impact of psychiatric diagnoses on physical health services utilization, mental health service utilization, and related health care costs among a cohort of individuals with serious mental disabilities enrolled for three years in Medicaid in Franklin County, Ohio. 4. To examine the impact of race on physical health service utilization, mental health service utilization, and related health care costs among a cohort of individuals with serious mental disabilities enrolled for three years in Medicaid in Franklin County, Ohio. The population of interest for research aim number one and two included those individuals designated as SMD by the Ohio Department of Mental Health. Subjects included those who were in Franklin County Alcohol, Drug and Mental Health Board administrative (ADAMH) database for SFY 1996. Subjects included only those identified as either African American or Caucasian, over the age of eighteen and living in the community (n=6550). The population of interest for research aims three and four included those individuals designated as SMD by the Ohio Department of Mental Health. Subjects included are either African American or Caucasian, over the age of eighteen and community dwelling. Subjects must also be continuously enrolled in Medicaid for three years (SFY 1996, SFY 1997, SFY 1998). This study involves a secondary analysis of data utilized in a previous study entitled, “Health Service Use and Cost of the SMD Population in Franklin, County, and Ohio”. Research aim one and two employed a cross-sectional design, and it examined the administrative claims data from ADAMH for SFY 1996 and the claims from Ohio Department of Jobs and Family Services for SFY 1996. The dependent variables were psychiatric diagnoses and Medicaid status. Independent variables included age, sex, and Medicaid status. Analysis was done using bivariate and multivariate statistics. Research aims three and four involved a multiyear cohort design that examined the ODJFS and ADAMH databases for SFY 1996, 1997, 1998. Dependent variables for this aim included health service utilization, prescription drug utilization, mental health treatments and health care costs. Independent variables included race, age sex, Medicaid status and psychiatric diagnoses. Analyses were done using bivariate and multivariate statistics. Analyses of aim one indicated that of the SMD population, who met the criteria for inclusion in the study 69.5% were Caucasian and 30.5% were African American. Fifty nine percent were females and 41% were males. The age category of the SMD clients reflects a wide range although the majority of clients are under the age of 44 (60%). Affective Psychoses (34%) and Schizophrenic Disorders (13%) comprised the largest diagnostic category of this population. Race was determined to influence psychiatric diagnoses with African Americans more likely to be diagnosed with Schizophrenic Disorders, Drug Dependence and Nondependent Drug Abuse. Caucasians were more likely to be diagnosed with Neurotic Disorders and Paranoid States. Analyses of aim two demonstrated that Medicaid status was variable and influenced by psychiatric diagnoses, age, and race. Over 50% of those with Schizophrenic Disorders and Affective Psychoses were receiving Medicaid in SFY 1996. Comorbid psychiatric diagnoses and race were predictors of current Medicaid enrollment status. This study suggests that psychiatric diagnoses have an important relationship to the receipt of public insurance. Analyses of aim three indicated that utilization of acute care services among the SMD population was remarkably high. Conversely, services received for women’s preventive health care, and dental and vision care were below that received by the general population, and below recommended clinical standards. Differences in patterns of physical and mental health services were noted by psychiatric diagnoses. Clients with Schizophrenic Disorders and Affective Psychoses received less physical health services and more mental health services. Analyses of aim four indicated that racial differences in psychiatric diagnoses, Medicaid and Medicare enrollment status, and the utilization of pharmaceutical agents occurred in this SMD population supporting previous research findings. Further research is needed in this domain to plan adequate and cost effective mental health service delivery systems.
Pamela Salsberry (Advisor)
338 p.
Health Sciences, Nursing
Serious Mentally Disabled; Medicaid Enrollment; Race

Recommended Citations

Citations

  • Chipps, E. M. (2003). Inlfuence of diagnoses, race, medicaid enrollment status on health service utilization among the seriously mentally disabled population [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1054149270

    APA Style (7th edition)

  • Chipps, Esther. Inlfuence of diagnoses, race, medicaid enrollment status on health service utilization among the seriously mentally disabled population. 2003. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1054149270.

    MLA Style (8th edition)

  • Chipps, Esther. "Inlfuence of diagnoses, race, medicaid enrollment status on health service utilization among the seriously mentally disabled population." Doctoral dissertation, Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=osu1054149270

    Chicago Manual of Style (17th edition)

osu1054149270
1,107
© 2003, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.