Assesses emergency department (ED) visits for adults and children 6 years of age and older with a diagnosis of mental illness or intentional self-harm and who received a follow-up visit for mental illness within 7 and 30 days.
Why It Matters
Mental illness can affect people of all ages. In the United States, 18% of adults and 13%–20% of children under 18 years of age experience mental illness.1,2 Research suggests that follow-up care for people with mental illness is linked to fewer repeat ED visits, improved physical and mental function and increased compliance with follow-up instructions.3,4,5
Results – National Averages
Follow-Up Within 7 Days of ED Visit
| Measurement Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2022 | 47.2 | 46.6 | 41.5 | 35.4 | 32.8 |
| 2021 | 48.1 | 48.4 | 40.1 | 35.1 | 30.7 |
| 2020 | 46.5 | 46.0 | 40.4 | 35.5 | 32.9 |
| 2019 | 46.8 | 45.3 | 41.4 | § | § |
| 2018 | 45.6 | 44.6 | 40.3 | 32.2 | 29.3 |
| 2017 | 45.9 | 44.9 | 40.0 | 32.0 | 29.0 |
Follow-Up Within 30 Days of ED Visit
| Measurement Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2022 | 63 | 63.1 | 55.2 | 51.4 | 47.5 |
| 2021 | 63.3 | 64 | 53.4 | 51 | 46.5 |
| 2020 | 61.2 | 60.7 | 54.4 | 51.0 | 48.2 |
| 2019 | 61.2 | 59.5 | 55.6 | § | § |
| 2018 | 60.1 | 59.5 | 54.8 | 48.5 | 44.5 |
| 2017 | 60.2 | 60.1 | 54.7 | 48.0 | 45.8 |
§ Not available due to CMS suspension of data reporting during COVID-19 pandemic.
This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.
Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via my.ncqa.org for analysis that accounts for trend breaks.
References
- Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
- Perou, R. et al. (2013). Mental Health Surveillance Among Children — United States, 2005–2011. Centers for Disease Control and Prevention- Morbidity and Mortality Weekly Report, 62(02), 1-35. Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/su6202a1.htm?s_cid=su6202a1_w
- Bruffaerts, R.., Sabbe, M., Demyffenaere, K. (2005). Predicting Community Tenure in Patients with Recurrent Utilization of a Psychiatric Emergency Service. General Hospital Psychiatry, 27, 269-74.
- Griswold, K.S., Zayas, L.E., Pastore, P.A., Smith, S.J., Wagner, C.M., Servoss, T.J. (2018) Primary Care After Psychiatric Crisis: A Qualitative Analysis. Annals of Family Medicine, 6(1), 38-43. doi:10.1370/afm.760.
- Kyriacou, D.N., Handel, D., Stein, A.C., Nelson, R.R. (2005). Brief Report: Factors Affecting Outpatient Follow-up Compliance of Emergency Department Patients. Journal of General Internal Medicine, 20(10), 938-942. doi:10.1111/j.1525-1497.2005.0216_1.x.