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Predictors of Treatment vs Nontreatment on Behavioral Health Patients in the Prehospital Setting

Author: Katerina Distler | |

Associate Authors: Helen E . Tripp | Melisa D. Martin

Introduction
Recent literature implies a lack of consistency in the management of behavioral health patients by healthcare providers despite the frequency of encounters. In addition, studies show social and public health issues may impact the rate of behavioral health complaints. Prehospital emergency medical providers regularly engage with behavioral health patients, often initiating their entry to the healthcare system. Additional research is needed to identify variables impacting potential inequities in prehospital care of behavioral health patients.

Objective

To develop a model analyzing the impact of multiple variables on whether or not behavioral health patients received treatment in the prehospital setting.

Methods

A retrospective study was conducted using national data collected between January 1, 2020 through December 31, 2020 from ESO Data Solutions. Patients included in the study were defined as those with a primary and/or secondary impression of behavioral, psychiatric, and/or substance use. A logistic regression model was used to analyze demographic variables impacting the likelihood that patients received care. Additionally, a chi-square examined trends in the frequency of care provision per month.

Results

A total of 739,965 patients met the inclusion criteria. Patients who identified as male (OR = 1.609, P = 0.000) were more Likely to receive care. Patients of Hispanic or Latino ethnicity (OR = 0.850, P < 0.001) were less likely to receive care. Additionally, patients of Black or African American race (OR = 0.843, P = 0.033) were less likely to receive care. Increasing age (OR = 1.002, P < 0.001) and monthly care trends (P < 0.001) were associated with a statistically significant but clinically irrelevant findings of care.

Conclusion

In this retrospective analysis of prehospital behavioral health patient data, providers were less likely to care for patients who identified as female, ethnically Hispanic or Latino, or racially Black or African American. The likelihood that care was provided increased with each year of age. Events occurring throughout 2020 had no clinically significant impact on the provision of care. Findings support the literature describing inconsistencies in healthcare provided for behavioral health patients and may indicate inequities within the prehospital system.