Mental Health
Predictors of Premature Mortality Among Medicaid Clients with Mental Illness

https://doi.org/10.1016/j.annepidem.2015.06.056Get rights and content

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Purpose

One in 17 adults in the United States live with a serious mental illness. Higher premature mortality rates are evident among persons with mental illness relative to the general population. Contributing factors for this disparity are not well understood. This investigation seeks to elucidate risk factors for premature mortality among Medicaid enrollees with mental illness.

Methods

A retrospective cohort mortality study of mental health clients enrolled in Delaware Medicaid as of January 1, 2011 was conducted for deaths occurring between January 1, 2011 through December 31, 2013. We evaluated associations with medical care utilization and premature mortality by fitting logistic regression models.

Results

6,257 mental health clients were identified and 99 deaths occurred in the cohort. The average age of death was 48.6 years compared to the Delaware average age of death of 78.4 years. Emergency room usage and total number of medical claims did not differ between those who died and those who did not. Mental health clients who died were more likely to have a comorbid disability (38.5% vs. 23.8%, p < 0.001), have increased hospitalizations in the past year (8.1 vs. 3.5, p < 0.01) and have higher

Conclusions

Delaware Medicaid recipients with mental illness had higher mortality rates compared to the US general population. Those who died prematurely had increased utilization of medical care, possibly due to more severe mental illness and comorbid disabilities.

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