One in every four visits in Colorado is for a child

A new analysis from the Colorado All Payer Claims Database (CO APCD) shows that over 17,000 Coloradans visiting an Emergency Department (ED) from 2016-2018 had a primary diagnosis related to mental health. One out of every four ED visits with a mental health diagnosis was for children under the age of 18.

Coloradans living with mental illness don’t always have access to comprehensive services or receive timely care to support their needs. Many efforts are underway in Colorado to improve diagnosis and treatment of mental health conditions, reduce stigma related to seeking care, and expand coverage and access to services for those living with mental illness. Despite these efforts, this new data indicates that emergency departments remain a source of support for many suffering from potentially preventable mental health crises.

The analysis was conducted by the Center for Improving Value in Health Care (CIVHC) using claims data for commercially insured, Medicaid and Medicare Advantage patients. Claims for ED visits that resulted in a mental health primary diagnosis were identified by evaluating over 200 ICD 10 codes, not including substance abuse-related diagnoses.

Results showed that across all age groups, Anxiety Disorder, Major Depressive Disorder and Panic Disorders were the top three diagnoses representing half of the mental health-related ED visits across all age groups and payers. For children under 18, the most frequent diagnosis was Major Depressive Disorder.

Trend analysis showed that across all age groups combined, ED visit rates for mental health reasons increased for Medicare Advantage patients, went down for Medicaid patients, and remained the same for those with commercial insurance between 2016 and 2018.

Geographic ED utilization rates based on location of residence was also compared across the nine Division of Insurance (DOI) regions in the state, and showed significant variation. In all years evaluated, the highest DOI region was more than three times that of the lowest DOI region.

In addition to the significant impact on health and well-being, costs associated with mental health-related ED visits totaled $25.8 million between patients and their insurers in 2018.

“We applaud the work of individuals and organizations working tirelessly to address mental health disparities in Colorado and across the U.S.” stated Ana English, President and CEO of CIVHC. “We hope this information is valuable to help communities benchmark, assess, and identify solutions to enhance support to those living with mental health conditions in the state.”

Complete methodology and downloadable data from this analysis is available by payer, age group, gender, DOI region and more at www.civhc.org.

Categories: CO APCDNews