Health services use among formerly incarcerated Louisiana Medicaid members within one year of release.
<h4>Objectives</h4>To determine the association between enrollment in Medicaid prior to release compared with post-release, and the use of health services and time to the first service use after release among Louisiana Medicaid members within one year of release from Louisiana state corr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0285582 |
| _version_ | 1797802019633758208 |
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| author | Ashley Wennerstrom Olivia K Sugarman Bruce Reilly Andrea Armstrong Angel Whittington Marcus A Bachhuber |
| author_facet | Ashley Wennerstrom Olivia K Sugarman Bruce Reilly Andrea Armstrong Angel Whittington Marcus A Bachhuber |
| author_sort | Ashley Wennerstrom |
| collection | DOAJ |
| description | <h4>Objectives</h4>To determine the association between enrollment in Medicaid prior to release compared with post-release, and the use of health services and time to the first service use after release among Louisiana Medicaid members within one year of release from Louisiana state corrections custody.<h4>Methods</h4>We conducted a retrospective cohort study linking Louisiana Medicaid and Louisiana state corrections release data. We included individuals ages 19 to 64 years released from state custody between January 1, 2017 and June 30, 2019 and enrolled in Medicaid within 180 days of release. Outcome measures included receipt of general health services (primary care visits, emergency department visits, and hospitalizations), cancer screenings, specialty behavioral health services, and prescription medications. To determine the association between pre-release Medicaid enrollment and time to receipt of health services, multivariable regression models were used which accounted for significant differences in characteristics between the groups.<h4>Results</h4>Overall, 13283 individuals met eligibility criteria and 78.8% (n = 10473) of the population was enrolled in Medicaid pre-release. Compared with those enrolled in Medicaid prior to release, those enrolled post-release were more likely to have an emergency department visit (59.6% versus 57.5%, p = 0.04) and hospitalization (17.9% versus 15.9%, p = 0.01) and less likely to receive outpatient mental health services (12.3% versus 15.2%, p<0.001) and prescription drugs. Compared with those enrolled in Medicaid prior to release, those enrolled post-release had a significantly longer time to receiving many services including a primary care visit (adjusted mean difference: 42.2 days [95% CI: 37.9 to 46.5; p<0.001]), outpatient mental health services (42.8 days [95% CI: 31.3 to 54.4; p<0.001]), outpatient substance use disorder service (20.6 days [95% CI: 2.0 to 39.2; p = 0.03]), and medication for opioid use disorder (40.4 days [95% CI: 23.7 to 57.1; p<0.001]) as well as inhaled bronchodilators and corticosteroids (63.8 days [95% CI: 49.3 to 78.3, p<0.001]), antipsychotics (62.9 days [95% CI: 50.8 to 75.1; p<0.001]), antihypertensives (60.5 days [95% CI: 50.7 to 70.3; p<0.001]), and antidepressants (52.3 days [95% CI: 44.1 to 60.5; p<0.001]).<h4>Conclusion</h4>Compared with Medicaid enrollment post-release, pre-release Medicaid enrollment was associated with higher proportions of, and faster access to, a wide variety of health services. Regardless of enrollment status, we found prolonged times between release and receipt of time-sensitive behavioral health services and prescription medications. |
| first_indexed | 2024-03-13T04:59:23Z |
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| id | doaj.art-1dc78436bb7d41b18854cfb0b63ae129 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-13T04:59:23Z |
| publishDate | 2023-01-01 |
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| spelling | doaj.art-1dc78436bb7d41b18854cfb0b63ae1292023-06-17T05:31:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01185e028558210.1371/journal.pone.0285582Health services use among formerly incarcerated Louisiana Medicaid members within one year of release.Ashley WennerstromOlivia K SugarmanBruce ReillyAndrea ArmstrongAngel WhittingtonMarcus A Bachhuber<h4>Objectives</h4>To determine the association between enrollment in Medicaid prior to release compared with post-release, and the use of health services and time to the first service use after release among Louisiana Medicaid members within one year of release from Louisiana state corrections custody.<h4>Methods</h4>We conducted a retrospective cohort study linking Louisiana Medicaid and Louisiana state corrections release data. We included individuals ages 19 to 64 years released from state custody between January 1, 2017 and June 30, 2019 and enrolled in Medicaid within 180 days of release. Outcome measures included receipt of general health services (primary care visits, emergency department visits, and hospitalizations), cancer screenings, specialty behavioral health services, and prescription medications. To determine the association between pre-release Medicaid enrollment and time to receipt of health services, multivariable regression models were used which accounted for significant differences in characteristics between the groups.<h4>Results</h4>Overall, 13283 individuals met eligibility criteria and 78.8% (n = 10473) of the population was enrolled in Medicaid pre-release. Compared with those enrolled in Medicaid prior to release, those enrolled post-release were more likely to have an emergency department visit (59.6% versus 57.5%, p = 0.04) and hospitalization (17.9% versus 15.9%, p = 0.01) and less likely to receive outpatient mental health services (12.3% versus 15.2%, p<0.001) and prescription drugs. Compared with those enrolled in Medicaid prior to release, those enrolled post-release had a significantly longer time to receiving many services including a primary care visit (adjusted mean difference: 42.2 days [95% CI: 37.9 to 46.5; p<0.001]), outpatient mental health services (42.8 days [95% CI: 31.3 to 54.4; p<0.001]), outpatient substance use disorder service (20.6 days [95% CI: 2.0 to 39.2; p = 0.03]), and medication for opioid use disorder (40.4 days [95% CI: 23.7 to 57.1; p<0.001]) as well as inhaled bronchodilators and corticosteroids (63.8 days [95% CI: 49.3 to 78.3, p<0.001]), antipsychotics (62.9 days [95% CI: 50.8 to 75.1; p<0.001]), antihypertensives (60.5 days [95% CI: 50.7 to 70.3; p<0.001]), and antidepressants (52.3 days [95% CI: 44.1 to 60.5; p<0.001]).<h4>Conclusion</h4>Compared with Medicaid enrollment post-release, pre-release Medicaid enrollment was associated with higher proportions of, and faster access to, a wide variety of health services. Regardless of enrollment status, we found prolonged times between release and receipt of time-sensitive behavioral health services and prescription medications.https://doi.org/10.1371/journal.pone.0285582 |
| spellingShingle | Ashley Wennerstrom Olivia K Sugarman Bruce Reilly Andrea Armstrong Angel Whittington Marcus A Bachhuber Health services use among formerly incarcerated Louisiana Medicaid members within one year of release. PLoS ONE |
| title | Health services use among formerly incarcerated Louisiana Medicaid members within one year of release. |
| title_full | Health services use among formerly incarcerated Louisiana Medicaid members within one year of release. |
| title_fullStr | Health services use among formerly incarcerated Louisiana Medicaid members within one year of release. |
| title_full_unstemmed | Health services use among formerly incarcerated Louisiana Medicaid members within one year of release. |
| title_short | Health services use among formerly incarcerated Louisiana Medicaid members within one year of release. |
| title_sort | health services use among formerly incarcerated louisiana medicaid members within one year of release |
| url | https://doi.org/10.1371/journal.pone.0285582 |
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