Ms. Grabert, Mr. Gertner, Dr. Domino, and Dr. Morrissey are with the Department of Health Policy and Management, Gillings School of Global Public Health, and Dr. Cuddeback is with the School of Social Work, University of North Carolina, Chapel Hill. The authors are also with the Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill.
Psychiatr Serv. 2017 Oct 1;68(10):1079-1082. doi: 10.1176/appi.ps.201600482. Epub 2017 May 1.
This study examined long-term outcomes (at 36 months) from Washington State's policy of expediting Medicaid enrollment for prison releasees with severe mental illness and compares them with previously reported short-term outcomes (at 12 months).
Linked administrative data on prison releasees (2006-2007) were analyzed by using a quasi-experimental design comparing those referred to expedited Medicaid (N=895) with a control group of those not referred (N=2,189). Aggregate outcomes were analyzed with inverse probability of treatment-weighted logit models.
Expedited Medicaid had a sustained effect on both increased months of enrollment (p<.01) and increased use of community mental health and general medical services (p<.01) 36 months after prison release. However, expedited Medicaid did not reduce criminal recidivism, consistent with 12-month findings, Conclusions: Outcome results at 12 months were sustained at 36 months-namely, expedited Medicaid for released prisoners with severe mental illness improved enrollment and service use with no effects on criminal recidivism.
本研究考察了华盛顿州为有严重精神疾病的监狱释放人员加速医疗补助计划（Medicaid）入保政策的长期结果（36 个月），并将其与之前报告的短期结果（12 个月）进行了比较。
通过使用准实验设计，对 2006-2007 年的监狱释放人员的相关行政数据进行了分析，比较了被转介到加速医疗补助计划的人员（895 人）和未被转介的对照组人员（2189 人）。使用逆概率治疗加权逻辑回归模型对总结果进行了分析。
加速医疗补助计划对增加入保月数（p<.01）和增加社区心理健康和一般医疗服务的使用（p<.01）均有持续影响，在监狱释放后 36 个月。然而，加速医疗补助计划并没有减少犯罪再犯率，与 12 个月的结果一致。
12 个月时的结果在 36 个月时得到了维持，即对有严重精神疾病的监狱释放人员进行加速医疗补助计划可以提高入保率和服务使用，对犯罪再犯率没有影响。
