Assessing the social determinants of health care costs for Medicaid-enrolled adolescents in Washington State using administrative data.

Abstract:

OBJECTIVE:The study used administrative data to identify the social determinants that have the greatest impact on Medicaid expenditures in adolescence. DATA SOURCES:Data were compiled using the Washington State Department of Social and Health Services Integrated Client Databases, which link data from state systems including Medicaid claims and social services receipt. STUDY DESIGN:Medical system and behavioral health service costs of over 180 000 Medicaid-enrolled adolescents aged 12-17 were measured using integrated administrative data from Washington State. Social determinants of health, including child maltreatment and parent risk factors, were also measured. Two-stage regression models were used to identify factors associated with increased health care utilization and costs. PRINCIPAL FINDINGS:Regression models revealed that the factors most predictive of higher health care costs were child abuse, child neglect, and instability in out-of-home placements related to foster care. Other social determinants of health, such as parent risk factors, were not associated with health care costs. Child maltreatment and placement instability impacted health care costs primarily through large increases in behavioral health utilization and costs. CONCLUSIONS:Prevention and early interventions for children and families to decrease child maltreatment and increase foster care placement stability could reduce overall health care costs.

journal_name

Health Serv Res

journal_title

Health services research

authors

Patton DA,Liu Q,Adelson JD,Lucenko BA

doi

10.1111/1475-6773.13052

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

52-63

issue

1

eissn

0017-9124

issn

1475-6773

journal_volume

54

pub_type

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