New research published in the journal Medical Care by Associate Professor Jie Chen (Health Services Administration) looks at the roles of local health departments in promoting mental health in reducing 30-day re-admission rates in Maryland. Thirty-day re-admission rates are a statistic considered as a quality measure under Medicare’s Readmissions Reduction Program. When hospitals exceed their targeted re-admission rate, they receive a financial penalty from Medicare.
Two School of Public Health graduate students were also actively involved in the research. Priscilla Novak and Deanna Barath, both doctoral students in the Department of Health Services Administration “have been actively involved in research to design a public health integrated model to promote population health," Dr. Chen said.
Novak, whose area of research interest is the integration of behavioral health, helped to design the study’s conceptual framework. Barath assisted with research on the local health departments in Maryland. Both work in Dr. Chen’s Hospital And Public health interdisciPlinarY research (HAPPY) Lab, which studies system-level care coordination among hospitals, communities, and public health agencies to improve population mental health and reduce health disparities.
The study’s objective was to examine whether local health departments’ promotion of mental health preventive care and services is associated with reductions in 30-day readmission rates for all causes. The researchers used data from the state of Maryland, the National Association of County and City Health Officials Profiles Survey, the Area Health Resource File, and U.S. Census data, and found that LHD direct provision of these services contributed to lower rates of readmission. “These estimated associations were more prominent among individuals with mental illness and/or substance use disorders, African Americans, Medicare, and Medicaid enrollees,” according to the study.
As a part of the overall strategy to improve quality and provide community benefit programs, hospitals are encouraged to connect with their community partners, including local public health departments. The researchers note that further research is necessary to evaluate local health department activities in other states to determine if results are generalizable. The results discussed in these manuscripts can inform additional research in this area to build the evidence base on the most effective ways for local health departments to partner with medical care delivery entities and community organizations to improve access to mental and physical health care and coordination of care across the continuum of health care and social services. If ongoing research demonstrates that local health departments can help hospitals achieve payment and quality goals, hospitals and other health care entities may be incentivized to invest in community partnerships and infrastructure to deliver higher quality services.