Behavioral health conditions, including mental health and substance abuse diagnoses, can be chronic and impact a patient’s well-being in many ways. When unmanaged or in severe cases, these conditions can become acute, resulting in an emergency department (ED) visit or requiring an inpatient stay.
ACHI developed an interactive dashboard to allow policymakers, healthcare providers, and community leaders to research acute behavioral health events in Arkansas at the state and county levels to better understand the behavioral health landscape and explore opportunities to improve care.
The dashboard below displays data on 86,431 acute behavioral health events that took place in Arkansas between 2020 and 2022 and includes emergency department visits, inpatient stays, prior or follow-up outpatient visits, patient demographics, geographic distribution, and frequency of encounters.
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.
“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.
Selecting a specific county, gender, age group, or payer type will filter the data across the entire dashboard. To preserve patient privacy, quantities fewer than 11 are suppressed and labeled as “Fewer than 11.” Values between 11 and 50 are grouped into ranges (e.g., “21-30”) to prevent the identification of small counts. Data used in this dashboard do not represent all Arkansans, which should be considered when interpreting results with percentages of 0% or 100%.
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 by 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:
- Year
- Event Type
- Diagnosis Group
- Patients or Encounters
- County or Statewide
- Sex
- Age Group
- Payer Type
RECURRING ENCOUNTERS VIEW
This view displays percentages of ED visits and inpatient stays that were followed by ED visits or inpatient stays by the same patients within 30 days. The diagnosis group for each recurring encounter was determined by using the primary diagnosis identified at the initial encounter. Recurring encounters include any ED visit or inpatient stay for any behavioral health-related category.
Percentages can be filtered by:
- Year
- Initial Event Type
- Recurring Event Type
- Diagnosis Group
- County
- Sex
- 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 visit 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:
- Year
- Event Type
- Diagnosis Group
- Prior Visit or Follow-Up
- Time Frame
- County
- Sex
- Age Group
- Payer Type
Additional criteria were used for ED visits and inpatient stays as defined below. These criteria are based on two measures included in Healthcare Effectiveness Data and Information Set measurement years 2020 and 2021: follow-up after hospitalization for mental illness and follow-up after emergency department visit for mental illness.
ED Visits: These exclude 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: These combine 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. Excluded are 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.