Hugunin, JulieDavis, MaryannLarkin, CelineBaek, JonggyuSkehan, BrianLapane, Kate L2023-02-022023-02-022022-10-12Hugunin J, Davis M, Larkin C, Baek J, Skehan B, Lapane KL. Established Outpatient Care and Follow-Up After Acute Psychiatric Service Use Among Youths and Young Adults. Psychiatr Serv. 2023 Jan 1;74(1):2-9. doi: 10.1176/appi.ps.202200047. Epub 2022 Oct 12. PMID: 36223162; PMCID: PMC9812848.1557-970010.1176/appi.ps.20220004736223162https://hdl.handle.net/20.500.14038/51638Objective: This study explored follow-up after hospitalization and emergency room (ER) use for mental health among youths and young adults with private insurance. Methods: The IBM MarketScan commercial database (2013-2018) was used to identify people ages 12-27 with a mental health hospitalization (N=95,153) or ER use (N=108,576). Factors associated with outpatient mental health follow-up within 7 and 30 days of discharge were determined via logistic models with generalized estimating equations that accounted for state variation. Results: Of those hospitalized, 42.7% received follow-up within 7 days (67.4% within 30 days). Of those with ER use, 28.6% received follow-up within 7 days (46.4% within 30 days). Type of established outpatient care predicted follow-up after hospitalization and ER use. Compared with people with no established care, the likelihood of receiving follow-up within 7 days was highest among those with mental health and primary care (hospitalization, adjusted odds ratio [AOR]=2.81, 95% confidence interval [CI]=2.68-2.94; ER use, AOR=4.06, 95% CI=3.72-4.42), followed by those with mental health care only (hospitalization, AOR=2.57, 95% CI=2.45-2.70; ER use, AOR=3.48, 95% CI=3.17-3.82) and those with primary care only (hospitalization, AOR=1.20, 95% CI=1.15-1.26; ER use, AOR=1.22, 95% CI=1.16-1.28). Similar trends were observed within 30 days of discharge. Conclusions: Follow-up rates after acute mental health service use among youths and young adults were suboptimal. Having established mental health care more strongly predicted receiving follow-up than did having established primary care. Improving engagement with outpatient mental health care providers may increase follow-up rates.enAcute careAdolescents/adolescenceHospitalizationMental healthPrimary careQuality of careUMCCTS fundingJournal ArticlePsychiatric services (Washington, D.C.)