TY - JOUR
AU - L. Tieu
AU - N. Pourat
AU - E. Bromley
AU - R. Simhan
AU - W. Zhou
AU - X. Chen
AU - B. Glenn
AU - R. Bastani
A1 - 
AB - Behavioral health integration (BHI) is increasingly implemented to expand capacity to address behavioral health conditions within primary care. Survey and claims data from the evaluation of the Public Hospital Redesign and Incentives in Medi-Cal program were used to examine the relationship between BHI and alcohol-related outcomes among Medicaid patients within 17 public hospitals in California. Key informant survey data measured hospital-level BHI at 3 levels (overall composite, infrastructure, and process domains, 10 themes). Multilevel logistic regression models estimated the relationship between BHI and outcomes indicating receipt of appropriate alcohol-related care (any primary care visit, any detoxification, timely initiation, timely engagement) and acute care (any emergency department [ED] visit or hospitalization, classified as alcohol-related or all-cause) in the year following an alcohol-related index encounter. Of 6196 patients, some had an alcohol-related primary care visit (33%), detoxification (16%), timely initiation (14%), or engagement in treatment (7%). ED visits resulting in discharge were more common (40% alcohol-related, 64% all-cause) than hospitalizations (15% alcohol-related, 26% all-cause). Controlling for patient-level characteristics, no significant relationships between overall BHI and these outcomes were observed. However, greater BHI infrastructure was associated with alcohol-related (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.14-3.05) and all-cause hospitalization (OR 1.25, 95% CI 1.01-1.55). Associations emerged between BHI themes (eg, related to support of providers) and greater likelihood of alcohol-related detoxification, primary care visit, timely initiation, and acute care utilization. Findings suggest that implementing specific BHI components may improve receipt of alcohol-related treatment, and warrant future research into these relationships.
AD - Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA.; Center for Healthcare Policy and Research, University of California, Davis, Sacramento, California, USA.; UCLA Center for Health Policy Research, Los Angeles, California, USA.; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA.; SJ Health, French Camp, California, USA.; Center for Cancer Prevention and Control Research and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California, USA.
AN - 39658035
BT - Popul Health Manag
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 2
DA - Apr
DO - 10.1089/pop.2024.0170
DP - NLM
ET - 20241210
IS - 2
JF - Popul Health Manag
LA - eng
N2 - Behavioral health integration (BHI) is increasingly implemented to expand capacity to address behavioral health conditions within primary care. Survey and claims data from the evaluation of the Public Hospital Redesign and Incentives in Medi-Cal program were used to examine the relationship between BHI and alcohol-related outcomes among Medicaid patients within 17 public hospitals in California. Key informant survey data measured hospital-level BHI at 3 levels (overall composite, infrastructure, and process domains, 10 themes). Multilevel logistic regression models estimated the relationship between BHI and outcomes indicating receipt of appropriate alcohol-related care (any primary care visit, any detoxification, timely initiation, timely engagement) and acute care (any emergency department [ED] visit or hospitalization, classified as alcohol-related or all-cause) in the year following an alcohol-related index encounter. Of 6196 patients, some had an alcohol-related primary care visit (33%), detoxification (16%), timely initiation (14%), or engagement in treatment (7%). ED visits resulting in discharge were more common (40% alcohol-related, 64% all-cause) than hospitalizations (15% alcohol-related, 26% all-cause). Controlling for patient-level characteristics, no significant relationships between overall BHI and these outcomes were observed. However, greater BHI infrastructure was associated with alcohol-related (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.14-3.05) and all-cause hospitalization (OR 1.25, 95% CI 1.01-1.55). Associations emerged between BHI themes (eg, related to support of providers) and greater likelihood of alcohol-related detoxification, primary care visit, timely initiation, and acute care utilization. Findings suggest that implementing specific BHI components may improve receipt of alcohol-related treatment, and warrant future research into these relationships.
PY - 2025
SN - 1942-7891
SP - 88
EP - 97+
ST - Assessing the Relationship Between Behavioral Health Integration and Alcohol-Related Treatment Among Patients with Medicaid
T1 - Assessing the Relationship Between Behavioral Health Integration and Alcohol-Related Treatment Among Patients with Medicaid
T2 - Popul Health Manag
TI - Assessing the Relationship Between Behavioral Health Integration and Alcohol-Related Treatment Among Patients with Medicaid
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U3 - 10.1089/pop.2024.0170
VL - 28
VO - 1942-7891
Y1 - 2025
ER -