Poverty, Preventable Stays, and Mental Health Shortage

Purpose

This analysis first aims to determine whether an area's poverty rate is related to preventable hospitalizations and readmission rates.

An HPSA indicates a shortage of primary care, dental health, or mental health providers based on geography, population, or facility. An HPSA designation could suggest that patients seeking care in that geography cannot find proper care and are "forced" to seek care elsewhere. This scenario explores county HPSAs related to mental health, emergency department (ED) use, and hospital and county demographics.

Preventable hospitalization and the overuse of the ED are ongoing concerns for health care delivery in the US (Sorel et al., 2015, Pezzin et al., 2018). Since 2010, the rate of ED utilization among young adults with mental illness has increased while overall use has decreased (Hernandez-Boussard et al., 2016). ED visits have increased from 44 million to 150 million since 1968 (Adams, 2013). There is a growing emphasis on improving care coordination and integrating mental health services to reduce preventable hospitalizations and decrease the ED burden (Talbot et al., 2016, Shen et al., 2018).

This scenario includes benchmarks for each appropriate variable. State-level benchmarks are accessible by filtering by state. Scenarios with multiple outcome variables require filtering by the specific outcome to return the corresponding benchmarks.

This data is also available in a text-based table format.

Utilization Mental Health 2022.xlsx (380.37 KB)

Tutorial Video
Data Sources
Defining The Columns

This tutorial video looks at Poverty, Preventable Stays, and Mental Health Shortages. The video guides you through how to use Tableau data analysis to determine whether an area's poverty rate is related to preventable hospitalizations and readmission rates.

Poverty, Preventable Stays, and Mental health Shortage Tutorial Video

Area Health Resources File (data released 2020)

State: The abbreviated name of the state where the county is located.

County: The name of the county where the information was collected. County names are listed as provided on the U.S. Census Bureau's list of 2020 FIPS Codes for Counties and County Equivalent Entities.

Mental Health HPSA: A county considered to have a shortage of mental health professionals, including psychiatrists, clinical psychologists, clinical social workers, psychiatric nurse specialists, and marriage and family therapists. This variable has three possible values:

None = None of the county designated as a shortage area;
Partial = The whole county designated as a shortage area;
Whole = One or more parts of the county designated as a shortage area.

Hospital Admissions: The number of patients, excluding newborns, accepted for inpatient service during the reporting period. The number includes patients who visit the emergency room and are later admitted for inpatient services. Neonatal and swing admissions are included.

Readmission Rate: This Medicare Beneficiary Fee-For-Service Hospital Readmission Rate is the percent of inpatient readmissions within 30 days of an acute hospital stay during the reference period.

Preventable Hospital Stays Rate: The hospital discharge rate for ambulatory care-sensitive conditions per 100,000 fee-for-service Medicare enrollees. This measure is age-adjusted.

Hospital Beds: The number of beds regularly maintained (set up and staffed for use) for inpatients as of the close of the reporting period.

FTEs: The number of full‑time personnel plus one‑half the number of part‑time personnel.

Inpatient Days: The number of adult and pediatric days of care, excluding newborn days of care, rendered during the entire reporting period. Neonatal and swing admissions are included.

Emergency Department Visits: The total count of inpatient or outpatient emergency department visits.

Outpatient Visits: The total count of hospital outpatient visits, which consists of emergency visits, other visits (including clinic and referred visits), and total visits. An outpatient visit is a visit by a patient not lodged in the hospital while receiving medical, dental, or other services.

Population Estimate: The total number of individuals residing in the county. The data is derived from the Census Population Estimates from 2020.

Percent in Poverty: The rate of individuals in the county with a total family income below the poverty threshold appropriate for that family.