健康与医学信息学杂志

Implementation of Behavioural and Medical Health Management Applications: Reducing High Intensity Medicaid Services Utilization for Individuals with Serious Mental Illness

Abstract

Thomas Uttaro, Boris Rybak and Karin Wagner

Health challenges for persons with serious mental illness and comorbid medical conditions are related to application design and usability. An application suite to improve community care was deployed in the community services division of South Beach Psychiatric Center, a large state-run facility in New York, USA. The association between the use of the Medicaid utilization application and changes in the use of Medicaid publicly paid medical inpatient and emergency services was evaluated. A Generalized Linear Mixed Model (GLMM) was developed and applied to assess for longitudinal (5-year) reductions in utilization, the impact of colocation of behavioural and medical health services, and the effects of intra subject correlation, zero inflation, and over-dispersion in the data. Significant reductions in the use of Medicaid paid inpatient and emergency services were observed. Colocation of services was not significant. Significant effects for intra subject correlation and zero inflation were obtained and accounted for in the model.