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Child Behavioral Health Service Use and Caregiver Strain: Comparison of Managed Care and Fee-For-Service Medicaid Systems

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Mental Health Services Research

Abstract

This study compares behavioral health service utilization patterns and their determinants among Medicaid-enrolled children, ages 5–17 (N = 676) who were being served under managed care in Tennessee or a traditional fee-for-service system in Mississippi. Children in the fee-for-service program were significantly more likely than their counterparts in the managed care Medicaid program to receive behavioral health services (i.e., any service, support services, traditional outpatient services, day treatment, inpatient/residential care) and to receive more services overall. This finding held after controlling for the influence of other factors. Although child, family, and community variables were related to service use patterns, the relationships differed across systems. Caregiver strain was associated with several service use variables, but its influence was more pronounced in Tennessee. These findings support continued focus on the multi-level factors that shape behavioral health service use among children.

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Authors and Affiliations

  1. Center for Evaluation and Program Improvement, Vanderbilt University, 1207 18th Avenue South, Nashville, Tennessee

    Ana María Brannan

  2. Department of Human and Organizational Development, Vanderbilt University, 230 Appleton Place, Peabody College #90, Nashville, Tennessee

    Craig Anne Heflinger

  3. Center for Evaluation and Program Improvement, Vanderbilt University, 2121 21st Avenue, Administration Building, 3rd Floor, Nashville, Tennessee

    Ana María Brannan

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  1. Ana María Brannan
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  2. Craig Anne Heflinger
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Correspondence to Ana María Brannan.

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María Brannan, A., Heflinger, C.A. Child Behavioral Health Service Use and Caregiver Strain: Comparison of Managed Care and Fee-For-Service Medicaid Systems. Ment Health Serv Res 7, 197–211 (2005). https://doi.org/10.1007/s11020-005-7452-z

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  • DOI: https://doi.org/10.1007/s11020-005-7452-z

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