Date of Conferral

2016

Degree

Ph.D.

School

Public Health

Advisor

Harold Griffin

Abstract

Large numbers of individuals utilize the ER each year for mental health reasons. The health home agency in this study was designed under the Affordable Care Act with the intention of increasing patient self-management thus decreasing high-cost service utilization. The effectiveness of health homes in reducing mental health-related ER visits has remained unexplored. In this study, the relationship between participation in this program and ER utilization was examined, using the theoretical framework of the Health Belief Model. The sample of 128 health home participants with documented mental health conditions was selected using systematic random sampling. A one-way, repeated-measures t-test and a one-way, repeated-measures ANCOVA were used to analyze hospital records for ER visits with a primary or secondary mental health diagnosis. The results indicated that health home participation did not have a statistically significant impact on ER utilization when comparing overall 12-month means or at quarterly anniversary dates when controlling for age, race, and gender. These findings suggested opportunities for improvement in professional practice, identified areas that require further research, and will be used to initiate discussion into the existing and potential value that health homes offer to the mental health clientele being served. Those discussions have the potential to create social change through infrastructure changes that lead to improved service coordination, increased resources for improving access and quality of care, and overall enhancement of outcomes for individuals with mental health conditions.

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