Racial Disparities in Outpatient Mental Health Service Use Among Children Hospitalized for Traumatic Brain Injury.
Megan Moore, Nathalia Jimenez, Janessa M Graves and 4 others
PMID 29194176WHAT IT FOUND
After discharge for pediatric TBI, racial minority Medicaid children were less likely to use outpatient mental health services than NHW children.
Inpatient use did not differ, so the gap appears after hospitalization.
Key findings
01During TBI hospitalization, mental health service use did not differ by race/ethnicity.
02In the first 3 months after discharge, NHB and Other children were significantly less likely to receive mental health services than NHW children.
03Between 4 and 12 months after discharge, NHB, Hispanic and Other children were significantly less likely to receive mental health services than NHW children.
STILL TO COME
How it was doneWhat they found
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What it does not show
This used Medicaid claims only, so mental health care provided in the community or billed to another payer was not counted. The database did not reveal family geography, socioeconomic details, or what children were in the Other race category. Unmeasured factors may remain, so the association may not be explained by race alone. Injury severity was estimated from claim codes rather than direct clinical detail. The study could not tell whether mental health services were for pre-existing problems or new problems after TBI. For Hispanic children, lower follow-up use may reflect prior need or prior service use, and sensitivity analyses had less power. Counting one service per day may miss multiple distinct services on the same day. Continuous enrollment sensitivity analyses reduced the sample size, so some estimates were less precise.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not read lower mental health service use as evidence that minority children need fewer services. The study counted Medicaid claims for psychiatric and psychological services, not the services each child needed.