Behavioral health events in the prenatal and postpartum periods impact mothers and their families during a critical time in their lives. As part of our continuing effort to examine each step along the birthing journey in Arkansas, ACHI developed an interactive dashboard to allow policymakers, healthcare providers, and community leaders to research acute behavioral health events, including mental health and substance abuse diagnoses, among Arkansas mothers at the state, regional, and county levels.
The dashboard below displays data on acute behavioral health events — those that result in an emergency department (ED) visit or inpatient stay — in the prenatal and postpartum periods among 80,704 Arkansas mothers who gave birth between Jan. 1, 2019, and June 30, 2022.
Key findings from ACHI’s analysis of the data are displayed in our maternal behavioral health infographic. They include:
- Behavioral health events were more likely to occur in the postpartum period compared to the prenatal period.
- Postpartum mothers consistently had lower follow-up visit rates after an emergency department visit or an inpatient stay compared to all women ages 18-44 in Arkansas.
- 59% of postpartum mothers had no outpatient follow-up behavioral health visit within 120 days of an emergency department visit.
- 56% of postpartum mothers had no outpatient follow-up behavioral health visit within 120 days of an inpatient stay.
See more information about maternal and infant health in Arkansas on our topic page.
About the Data
The data presented here were obtained through the Arkansas Healthcare Transparency Initiative (HTI), which includes the Arkansas All-Payer Claims Database (APCD). The APCD includes enrollment records and medical and pharmacy claims for commercial plans, Medicaid fee-for-service (FFS), Medicaid qualified health plans, Medicaid Provider-Led Arkansas Shared Savings Entity (PASSE) plans, and Medicare Advantage plans. The HTI also contains emergency department and inpatient data identified as “self-pay,” meaning that the source of payment was out-of-pocket. These data include Arkansas mothers who gave birth between Jan. 1, 2019, and June 30, 2022.
“Behavioral health” includes mental health diagnoses, developmental disorders, and substance use disorders, among others. Acute behavioral health events are defined as those that result in an ED visit or inpatient stay.
Measures are displayed by:
- Total
- Region
- County
- Perinatal Period
- Age Group
- Payer
Selecting a specific county, perinatal period, age group, or payer will filter the data for the entire dashboard. Data fields with quantities less than 11 are suppressed to preserve patient privacy. In some cases, this will result in empty or incomplete fields.
PATIENTS AND ENCOUNTERS VIEW
This view displays counts of distinct patients with behavioral health events and counts of behavioral health encounters, categorized by either ED visits or inpatient stays and diagnosis group. ED visits and inpatient stays are defined as follows:
Emergency Department (ED) Visits: An ED visit was identified when a patient had a medical claim for a service provided in an ED with a primary diagnosis in the behavioral health-related categories of the Clinical Classifications Software Refined (CCSR). ED visits that led directly to inpatient stays were excluded from these counts.
Inpatient Stays: An inpatient stay was identified when a patient had a medical claim for an overnight stay in a hospital with a primary diagnosis in the behavioral health-related categories of the CCSR. Inpatient stays that occurred within one day of each other were counted as one inpatient stay.
Measures can be filtered by:
- Event Location
- Diagnosis Group
- Patients or Encounters
- State, County, or Region
- Perinatal Period
- Age Group
- Payer Type
RECURRING ENCOUNTERS VIEW
This view displays counts of distinct patients with behavioral health events and counts of behavioral health encounters, categorized by either ED visits or inpatient stays and diagnosis group. ED visits and inpatient stays are defined as follows:
Emergency Department (ED) Visits: An ED visit was identified when a patient had a medical claim for a service provided in an ED with a primary diagnosis in the behavioral health-related categories of the Clinical Classifications Software Refined (CCSR). ED visits that led directly to inpatient stays were excluded from these counts.
Inpatient Stays: An inpatient stay was identified when a patient had a medical claim for an overnight stay in a hospital with a primary diagnosis in the behavioral health-related categories of the CCSR. Inpatient stays that occurred within one day of each other were counted as one inpatient stay.
Measures can be filtered by:
- Event Location
- Diagnosis Group
- Patients or Encounters
- State, County, or Region
- Perinatal Period
- Age Group
- Payer Type
OUTPATIENT VISITS VIEW
This view displays percentages of ED visits or inpatient stays that were preceded or followed by outpatient visits by the same patients within a selected time frame. Qualifying outpatient visits are defined below:
Outpatient Visits: An outpatient visit was identified when a patient who had a behavioral health-related ED visit or inpatient stay also had an outpatient or telehealth visit with a primary diagnosis identified in the behavioral health-related categories of the CCSR. The closest qualifying outpatient visit to the patient’s ED visit or inpatient stay admit date was used to calculate the time prior to the encounter, and the closest qualifying outpatient visit to the ED visit or inpatient stay discharge date was used to calculate the time to follow-up. An outpatient visits that occurred on the same date as the ED visit or inpatient stay was not included as prior or follow-up outpatient care.
Percentages can be filtered by:
- Event Location
- Diagnosis Group
- Prior Visit or Follow-Up
- Time Frame
- State, County, or Region
- Perinatal Period
- Age Group
- Payer Type
Additional criteria were used for ED visits and inpatient stays as defined below. These criteria are based on Healthcare Effectiveness Data and Information Set measurement years 2020 and 2021 metrics for “Follow-Up After Hospitalization for Mental Illness” and “Follow-Up After Emergency Department Visit for Mental Illness.”
ED Visits: This view excludes ED visits by patients who had an inpatient stay of any kind starting within 30 days of the ED visit and ED visits by patients who had another behavioral health-related ED visit within the previous 30 days. Also excluded are ED visits by patients who had evidence of any nursing home stay, hospice care, or intermediate healthcare facility stay within 30 days before or after the ED visit.
Inpatient Stays: This view combines behavioral health-related inpatient stays that occurred within 30 days of each other into a single event — the first stay’s admission date is recorded as the admit date, and the last stay’s discharge date becomes the end date. It excludes inpatient stays by patients who had another inpatient stay of any kind other than behavioral health within 30 days of the final discharge date. Also excluded are inpatient stays by patients who had evidence of any nursing home stay, hospice care, or intermediate healthcare facility stay within 30 days before or after the inpatient stay.