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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Screening for behavioral health issues in children enrolled in massachusetts medicaid
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Screening for behavioral health issues in children enrolled in massachusetts medicaid

机译：筛查马萨诸塞州医疗儿童的行为健康问题

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OBJECTIVES: To understand mandated behavioral health (BH) screening in Massachusetts Medicaid including characteristics of screened children, predictors of positive screens, and whether screening identifies children without a previous BH history. METHODS: Massachusetts mandated BH screening in particularly among underidentified groups. 2008. Providers used a billing code and modifier to indicate a completed screen and whether a BH need was identified. Using MassHealth claims data, children with ≥300 days of eligibility in fiscal year (FY) 2009 were identified and categorized into groups based on first use of the modifier, screening code, or claim. Bivariate analyses were conducted to determine differences among groups. BH history was examined by limiting the sample to those continuously enrolled in FY 2008 and 2009. Multivariate logistic regression was used to determine predictors of positive screens. RESULTS: Of 355 490 eligible children, 46% had evidence of screening. Of those with modifiers, 12% were positive. Among continuously enrolled children (FY 2008 and FY 2009) with evidence of screening, 43% with positive modifiers had no BH history. This "newly identified" group were more likely to be female, younger, minority, and from rural residences (P < .0001). Among children with modifiers; gender (male), age (5-7), being in foster care, recent BH history, and Hispanic ethnicity predicted having a positive modifier. CONCLUSIONS: The high rate of newly identified Medicaid children with a BH need suggests that screening is performing well, particularly among underidentified groups. To better assess screening value, future work on cost-effectiveness and the impact on subsequent mental health treatment is needed.
机译：目的：了解马萨诸塞州医疗补助计划的强制性行为健康（BH）筛查，包括被筛查儿童的特征，阳性筛查的预测因素以及筛查是否可识别没有先前BH史的儿童。方法：马萨诸塞州特别在身份不明的人群中强制进行BH筛查。 2008年。提供商使用帐单代码和修饰符来指示完成的屏幕以及是否已识别出BH需求。使用MassHealth索赔数据，根据首次使用修饰符，筛查代码或索赔，确定2009财政年度（FY）≥300天合格的儿童，并将其分类。进行双变量分析以确定组之间的差异。通过将样本限制为2008和2009财政年度连续入选的样本来检查BH历史。使用多因素logistic回归确定阳性筛查的预测因子。结果：在355 490名合格儿童中，有46％有筛查证据。在那些使用修饰语的人中，有12％是积极的。在有筛查证据的连续入学儿童（2008财年和2009财年）中，有43％带有阳性修饰语的儿童没有BH史。这个“新发现”的人群更可能是女性，年轻，少数民族和农村居民（P <.0001）。在有修饰语的儿童中;性别（男），年龄（5-7），正在寄养，最近的BH历史和西班牙裔种族预测具有积极的修饰语。结论：新近确定的有BH需求的Medicaid儿童的高比率表明筛查效果良好，尤其是在身份不明的人群中。为了更好地评估筛查价值，需要就成本效益及其对后续心理健康治疗的影响开展进一步的工作。

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