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Child Sociodemographic Characteristics and Common Psychiatric Diagnoses in Medicaid Encounter Data: Are they Valid?

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Abstract

This study describes the rate that Medicaid encounter data on gender, race/ethnicity, and diagnosis matched information in the medical record, among a statewide sample of Medicaid children who received ongoing care for attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), and major depression (MD) in outpatient specialty mental health clinics in 1998–1999. The match rate for gender was 99%; and for race/ethnicity it was 71.8%, 90.5%, and 89.7% for Caucasian, African American, and Hispanic children, respectively. Misidentified Caucasian children were more likely to be recorded as African American or Hispanic than misidentified minority children to be recorded as Caucasian. Diagnosis match rates were high (ADHD: 98%, CD: 89%, MD: 89%). If the California Department of Mental Health relied solely on Medicaid encounter data, misclassification of African American or Hispanic children as Caucasian could produce an underestimate of their service use.

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Acknowledgments

This study was supported by the State of California Department of Mental Health and the National Institute of Mental Health (P30 MH68639, P50 MH546230, P50 MH50313). The authors gratefully acknowledge Dr. Stephen Mayberg, Director of the State of California Department of Mental Health, for his outstanding leadership, and the California Mental Health Directors Association and California Mental Health Planning Council for their cooperation that made this study possible. The information contained in this report reflects the author's views, and not necessarily the views or position of the Department of Mental Health.

Author information

Correspondence to Penelope K. Knapp MD.

Additional information

Michael S. Hurlburt, PhD, is a research scientist at Child and Adolescent Services Research Center, Children's Hospital, San Diego, 3020 Children's Way, San Diego, CA 92123-0282, USA.

Eric C. Kostello, PhD, is a research sociologist at University of California at Los Angeles, Health Services Research Center, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA 90024-6505, USA.

Heather Ladd, MS, is a data analyst at University of California at Los Angeles, Health Services Research Center, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA 90024-6505, USA.

Lingqi Tang, PhD, is a statistician at University of California at Los Angeles, Health Services Research Center, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA 90024-6505, USA.

Bonnie T. Zima, MD, MPH, is a professor-in-residence of the Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Health Services Research Center, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA 90024-6505, USA.

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Knapp, P.K., Hurlburt, M.S., Kostello, E.C. et al. Child Sociodemographic Characteristics and Common Psychiatric Diagnoses in Medicaid Encounter Data: Are they Valid?. J Behav Health Serv Res 33, 444–452 (2006). https://doi.org/10.1007/s11414-006-9024-4

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Keywords

  • Attention Deficit Hyperactivity Disorder
  • Major Depression
  • Conduct Disorder
  • Attention Deficit Hyperactivity Disorder
  • Claim Data