Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 1;62(8):538-542.
doi: 10.1097/MLR.0000000000002022. Epub 2024 Jun 11.

Provision of Behavioral Health Services at Community Health Centers and Hospital Emergency Department Visits

Kathleen Carey  1 , Megan B Cole
Affiliations

Provision of Behavioral Health Services at Community Health Centers and Hospital Emergency Department Visits

Kathleen Carey et al. Med Care. .

Abstract

Background: Numerous US patients seek the hospital emergency department (ED) for behavioral health care. Community Health Centers (CHCs) offer a potential channel for redirecting many to a more patient-centered, lower cost setting.

Objective: The aim of this study was to identify unique market areas serviced by CHCs and to examine whether CHCs are effective in offsetting behavioral health ED visits.

Research design: We identified CHC-year specific service areas using patient origin zip codes. We then estimated random effects models applied to 42 federally qualified CHCs operating in New York State during 2013-2020. The dependent variables were numbers of ED mental health (substance use disorder) visits per capita in a CHC's service area, drawn from HCUP State Emergency Department Databases. Key explanatory variables measured CHC number of mental health (substance use disorder) visits, number of unique mental health (substance use disorder) patients, and mental health (substance use disorder) intensity, obtained from the HRSA Uniform Data System.

Results: Controlling for population, we observed small negative effects of CHC behavioral health integration in explaining ED behavioral health utilization. Measures of mental health utilization in CHCs were associated with 1.3%-9.3% fewer mental health emergency department visits per capita in Community Health Centers' service areas. Measures of substance use disorder utilization in Community Health Centers were associated with 1.3%-3.0% fewer emergency department visits per capita.

Conclusion: Results suggest that behavioral health integration in CHCs may reduce reliance on hospital EDs, but that policymakers explore more avenues for regional coordination strategies that align services between CHCs and local hospitals.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

References

    1. National Institute of Mental Health. Mental illness. 2024. Accessed May 31, 2024. https://www.nimh.nih.gov/health/statistics/mental-illness .
    1. US Department of Health and Human Services. SAMHSA announces National Survey on Drug Use and Health (NSDUH) results detailing mental illness and substance use levels in 2021; 2023. Accessed May 31, 2024. https://www.hhs.gov/about/news/2023/01/04/samhsa-announces-national-surv... .
    1. Shah H. Rise in emergency in department visits due to limited access to behavioral health services. Institute for Health Policy Leadership, Loma Linda University Health; 2022. Accessed May 31, 2024. https://ihpl.llu.edu/blog/rise-emergency-department-visits-due-limited-a... .
    1. Coster JE, Turner JK, Bradbury D, et al. Why do people choose emergency and urgent care services? A rapid review utilizing a systematic literature search and narrative synthesis. Acad Emerg Med. 2017;24:1137–1149.
    1. Vogel JA, Rising KL, Jones J, et al. Reasons people choose the emergency department over primary care: a qualitative synthesis. J Gen Intern Med. 2019;34:2610–2619.

MeSH terms