Article

OBJECTIVE: To examine racial differences in mental health service utilization
after hospitalization for traumatic brain injury (TBI) among children with
Medicaid insurance. DESIGN : Retrospective analysis of the
MarketScan Multi-State Medicaid database from 2007 to 2012 was performed.
Outpatient mental health service utilization (psychiatric and psychological
individual and group services) was compared at TBI hospitalization, from
discharge to 3 months and from 4 to 12 months after discharge, between children
of non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, and "Other"
racial groups. Multivariable mixed-effects Poisson regression models with robust
standard errors were utilized. RESULTS: A total of 5674 children (aged <21 years)
were included in the study. There were no differences by race/ethnicity in mental
health service utilization during hospitalization. At 3 months postdischarge, NHB
children and children in the "Other" racial category were significantly less
likely to receive outpatient mental health services than NHW children (NHB
relative risk [RR] = 0.84; 95% confidence interval [CI], 0.72-0.98; Other RR =
0.72; 95% CI, 0.57-0.90). At 12 months, all racial minority children were
significantly less likely to receive outpatient mental health services than NHW
children (NHB RR = 0.84; 95% CI, 0.75-0.94; Hispanic RR = 0.72; 95% CI,
0.55-0.94; Other RR = 0.71; 95% CI, 0.60-0.84). CONCLUSIONS: Racial disparities
in utilization of outpatient mental health services exist for minority children
hospitalized for TBI and insured by Medicaid. Future research should focus on
improving transitions of care from inpatient to outpatient services for these children.

Langue : ANGLAIS