Seniors who were hospitalised for a psychiatric illness were less likely to get recommended follow-up care if their Medicare plans required that they pay more for mental health care than for other medical care, researchers have found.
“We have solid evidence that people who get appropriate care after leaving the hospital are less likely to be readmitted to the hospital and have better mental health outcomes,” said Dr. Amal N. Trivedi, assistant professor of community health at the Warren Alpert Medical School at Brown University and an author of the study.
“What our study found is that these co-payments act as a pretty potent barrier to getting appropriate care,” he added.
The study, published recently in The Journal of the American Medical Association, reviewed the records of 43,892 Medicare beneficiaries who had been hospitalised for a mental illness between 2001 and 2006.
Beneficiaries who incurred the same out-of-pocket costs for mental health visits as for any other doctor visit were 10.9 percent more likely to get recommended follow-up care within a week of being released from a psychiatric hospital than were those who had to pay more for mental health care, the researchers found.
Overall rates of follow-up care were low, however. Only 45 percent of seniors who had parity in coverage — meaning they paid the same for mental health visits as for other doctor visits — obtained follow-up treatment within seven days of discharge from a psychiatric hospitalization, compared to 32 percent of those who did not have parity.
The gap was nearly 11 percent after figures were adjusted for differences in patients’ gender, race and socioeconomic status, the researchers said.
The vast majority of Medicare plans require patients to pay more for mental health care visits than for other care, the study found. That should change by 2010, when a new federal law requiring parity in cost-sharing for mental health services goes into effect.
From a report in the New York Times
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