The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State
Abstract Background Timothy's law to reduce mental health care disparities was enacted in January 2007 in New York state (NY). According to Timothy's law, "if a patient is suffering from a Biologically Based Mental Illness, or is a Child with Serious Emotional Disturbances, the Inpati...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | International Journal of Mental Health Systems |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13033-022-00535-w |
| _version_ | 1811248835092021248 |
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| author | Mingfei Li Victor S. Y. Lo Piaomu Liu Eric Smith |
| author_facet | Mingfei Li Victor S. Y. Lo Piaomu Liu Eric Smith |
| author_sort | Mingfei Li |
| collection | DOAJ |
| description | Abstract Background Timothy's law to reduce mental health care disparities was enacted in January 2007 in New York state (NY). According to Timothy's law, "if a patient is suffering from a Biologically Based Mental Illness, or is a Child with Serious Emotional Disturbances, the Inpatient mental health benefit will be the same as for any other illness". An assessment of its impact on inpatient mental health care is lacking. We provide a rigorous study of this policy intervention’s effect over the first year of its implementation. Methods We used a quasi-experimental design to combine the difference-in-difference method and propensity score weighting. Data are from inpatient records in NY and California (CA) (as a control) between January 2006 to December 2006 (the pre-enactment year in NY) and January to December 2007 (the enactment year) for non-Medicare/Medicaid patients hospitalized in both years with specific illnesses covered by Timothy's Law. Change in length of stay from 2006 to 2007 was measured for each patient, and the differences observed in NY and California were compared to each other (Difference-in-Difference), with differences in the characteristics of patients in NY and California addressed through Propensity Score Weighting (PSW). Results Before Timothy's Law was enacted (2006), length of stay (LOS) in NY was 16.3 days on average, and length of stay per hospitalization (LOSPH) was 11.72 days on average for the 1237 patients under study in 2006. In 2007, LOS increased by 4.91 days in NY (95% CI (2.89, 7.01)) compared with similar patients in California, and LOSPH by 3.25 days (95% CI (1.96, 4.57)). Among patients with serious mental illness diagnoses, LOS in NY increased by 7.07 days (95% CI (4.15, 10.17)), and LOSPH by 4.04 days (95% CI (1.93, 6.03)) compared to California. Conclusions Our study strongly suggests that, within the time frame of just a single year, Timothy's Law significantly increased inpatient mental healthcare utilization in NY. Our study raises the possibility that similar laws in other locations could have similar effects. |
| first_indexed | 2024-04-12T15:34:59Z |
| format | Article |
| id | doaj.art-df7773039fd148c589b72145f433d671 |
| institution | Directory Open Access Journal |
| issn | 1752-4458 |
| language | English |
| last_indexed | 2024-04-12T15:34:59Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Mental Health Systems |
| spelling | doaj.art-df7773039fd148c589b72145f433d6712022-12-22T03:26:58ZengBMCInternational Journal of Mental Health Systems1752-44582022-05-011611910.1186/s13033-022-00535-wThe impact of Timothy's Law on hospitalization among patients with mental health conditions in New York StateMingfei Li0Victor S. Y. Lo1Piaomu Liu2Eric Smith3Department of Mathematical Sciences, Bentley UniversityWorkplace Investing, Fidelity InvestmentsDepartment of Mathematical Sciences, Bentley UniversityCenter for Healthcare Organization and Implementation Research (CHOIR), Bedford VA Healthcare SystemAbstract Background Timothy's law to reduce mental health care disparities was enacted in January 2007 in New York state (NY). According to Timothy's law, "if a patient is suffering from a Biologically Based Mental Illness, or is a Child with Serious Emotional Disturbances, the Inpatient mental health benefit will be the same as for any other illness". An assessment of its impact on inpatient mental health care is lacking. We provide a rigorous study of this policy intervention’s effect over the first year of its implementation. Methods We used a quasi-experimental design to combine the difference-in-difference method and propensity score weighting. Data are from inpatient records in NY and California (CA) (as a control) between January 2006 to December 2006 (the pre-enactment year in NY) and January to December 2007 (the enactment year) for non-Medicare/Medicaid patients hospitalized in both years with specific illnesses covered by Timothy's Law. Change in length of stay from 2006 to 2007 was measured for each patient, and the differences observed in NY and California were compared to each other (Difference-in-Difference), with differences in the characteristics of patients in NY and California addressed through Propensity Score Weighting (PSW). Results Before Timothy's Law was enacted (2006), length of stay (LOS) in NY was 16.3 days on average, and length of stay per hospitalization (LOSPH) was 11.72 days on average for the 1237 patients under study in 2006. In 2007, LOS increased by 4.91 days in NY (95% CI (2.89, 7.01)) compared with similar patients in California, and LOSPH by 3.25 days (95% CI (1.96, 4.57)). Among patients with serious mental illness diagnoses, LOS in NY increased by 7.07 days (95% CI (4.15, 10.17)), and LOSPH by 4.04 days (95% CI (1.93, 6.03)) compared to California. Conclusions Our study strongly suggests that, within the time frame of just a single year, Timothy's Law significantly increased inpatient mental healthcare utilization in NY. Our study raises the possibility that similar laws in other locations could have similar effects.https://doi.org/10.1186/s13033-022-00535-wMental health servicesMental care disparitiesPolicy evaluationCausal inference |
| spellingShingle | Mingfei Li Victor S. Y. Lo Piaomu Liu Eric Smith The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State International Journal of Mental Health Systems Mental health services Mental care disparities Policy evaluation Causal inference |
| title | The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State |
| title_full | The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State |
| title_fullStr | The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State |
| title_full_unstemmed | The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State |
| title_short | The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State |
| title_sort | impact of timothy s law on hospitalization among patients with mental health conditions in new york state |
| topic | Mental health services Mental care disparities Policy evaluation Causal inference |
| url | https://doi.org/10.1186/s13033-022-00535-w |
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